‘Risk sharing’ revives health care bill
Plan to lower premiums brings Republicans closer to agreement on replacing Obamacare
House Speaker WASHINGTON Paul Ryan announced a Republican agreement Thursday on legislative language that he said will bring the chamber closer to passing a bill to repeal and replace the Affordable Care Act.
Ryan, who canceled a vote on repeal legislation that divided his caucus last month, said the House will add language to the draft bill to create a federal risksharing program that he said would lower premiums and add protections for people facing challenges getting access to affordable care.
The $15 billion proposal for a Federal Invisible Risk Sharing Program, as described in a memo from House Majority Leader Kevin McCarthy, R-Calif., is designed to help states reduce premiums by reimbursing health insurance issuers for high-cost individuals — those with significant health problems — beginning in 2018.
The proposal by Reps. Gary Palmer of Alabama and David Schweikert of Arizona is modeled after a program in Maine.
“This promise is just too important and the consequences of inaction are too dire for American families for us to give up,” Ryan said.
He said the amendment makes the American Health Care Act a better bill and lawmakers are working on other consensus ideas.
The divide between the staunchly conservative Freedom Caucus members and the more moderate wing of House Republicans is “narrowing quickly,” he said. Many Freedom Caucus members refused to support the earlier version of the bill, and efforts to add language to woo them led Republican moderates to turn against the bill.
Democrats have pushed for increasing reimbursements to insurance companies for high claims under the Affordable Care Act as a way to entice insurers into the individual market and bring down costs.
But House Minority Leader Nancy Pelosi, D-Calif., said during a news conference Thursday that the new Republican proposal only puts a “Band-Aid on that horrible, monstrous bill.”
“They are desperate to keep Trumpcare alive, continuing their campaign to raise massive costs on seniors and hardworking families,” she said.
It’s unclear how the Republi- can plan would handle protections for those with pre-existing conditions. The Affordable Care Act mandates that insurers provide coverage regardless of a person’s medical history. The Freedom Caucus has called for amendments that would allow states to opt out of those requirements. Ryan didn’t rule out the proposal.
“I’m not going to get into the particular details of the conversations that are going on,” he said, “but we believe that there are additional reforms and ideas that can do both things, protect people with pre-existing conditions and continue to lower premiums and give states flexibility so that more insurers can come into the marketplace.”
Even with the new language, it is unclear when Republicans might be in position to bring the bill to the floor. Ryan said negotiations are ongoing within the Republican caucus. The House is scheduled to be out of session for the next two weeks, but McCarthy didn’t rule out calling the House back into session.
“Should we be prepared to advance our bill through the House in the coming two weeks, we will advise members immediately and give you sufficient time to return to Washington,” he wrote in a memo to GOP members.
Palmer said the risk-sharing arrangement would be a federal program for three years, then the states would be able to take it over. The program reduced premiums in Maine and increased the number of insured, he said.
“We’re going to see premiums coming down, I think, perhaps by next year,” Palmer said.
Schweikert said the proposal is designed to address the need for people with chronic conditions to stay in the health care system while mitigating some of the “extraordinary costs” transferred to others trying to buy insurance.
“This promise is just too important and the consequences of inaction are too dire for American families for us to give up.” House Speaker Paul Ryan