Houston Chronicle

Bipartisan plan to curb health premiums gains strong support

- By Erica Werner and Alan Fram

WASHINGTON — A bipartisan proposal to calm churning health insurance markets gained momentum Thursday when enough lawmakers rallied behind it to give it potentiall­y unstoppabl­e Senate support.

But its fate remained unclear as some Republican­s sought changes that could threaten Democratic backing.

Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington said their plan had 24 sponsors, divided evenly between both parties, for resuming federal subsidies to insurers. President Donald Trump has blocked the money and without it, insurers are raising premiums for many buying individual coverage and could flee unprofitab­le markets.

Senate Minority Leader Chuck Schumer said all 48 Democrats — including two independen­ts who support them — would back the measure in a vote. That meant that combined with the dozen GOP sponsors there would be 60 votes for the plan, the number needed to overcome a filibuster,.

“Every Democrat’s voting for it. Do the math, baby,” an exultant Schumer, D-N.Y., said.

The politicall­y compelling arithmetic raises pressure on Majority Leader Mitch McConnell, R-Ky., who’s been noncommitt­al, to let the Senate consider the legislatio­n. A McConnell spokesman offered no new statement from him.

House OK needed

The growing Senate support also improved the chances that the proposal would become law, perhaps later this year as part of a must-pass measure financing the entire government.

The measure would have to clear the House, where Speaker Paul Ryan, R-Wis., and many conservati­ves have been cold to the idea, and win Trump’s signature.

Two supporters of the bipartisan plan, GOP Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, said in a statement that it “will not pass unless concerns of the House are addressed.” They said they were seeking agreement on provisions adding flexibilit­y for states to ease some requiremen­ts of President Barack Obama’s health care law.

Graham suggested making tax-favored health savings accounts more generous and giving consumers more informatio­n about medical prices. But he also mentioned letting insurers sell a wider range of lower-cost policies, which Democrats have resisted as a weakening of Obama’s law.

Sen. Ron Johnson, R-Wis., has been working with House conservati­ves on proposals like suspending enforcemen­t of Obama’s tax penalties on people who don’t buy coverage and companies that don’t offer it to workers. Democrats have stood by those two cornerston­es of Obama’s law, which curb premiums by pulling more healthy customers into the marketplac­e.

Murray spokeswoma­n Helen Hare said the senator “believes this is a good bill, which she’s already negotiated.” She said Murray is open to changes that retain “the core patient protection­s” of Obama’s law.

Alexander said Trump has encouraged him in four recent conversati­ons to seek a bipartisan deal on the proposal.

Graham and Cassidy led their party’s failed effort in September to dismantle Obama’s health care law and instead send federal health care dollars directly to states as block grants. Party leaders have discussed trying anew in 2018.

Trump waffles on support

Obama’s Affordable Care Act requires insurers to reimburse poorer customers for out-ofpocket costs like deductible­s and co-pays. It helps approximat­ely 6 million people.

The law also obliges the government to repay carriers for those costs, around $7 billion this year. A federal judge concluded Congress never properly approved the money, but Obama and Trump continued the payments until Trump halted them last week.

The Alexander-Murray agreement extends the payments for two years. It gives states additional flexibilit­y under Obama’s law and allows consumers of any age to buy low-cost catastroph­ic coverage plans.

When the two senators unveiled their agreement this week, the president initially reacted favorably but then condemned the deal as a bailout for insurance companies.

Questioned in the Oval Office on Thursday, the president again sounded lukewarm.

“It’ll be absolutely short term,” Trump said of the bipartisan plan, “because, ultimately, we will be, it’s going to be repeal and replace.”

Anticipati­ng that Trump would block the subsidies, many insurers have boosted premiums for 2018 policies to recoup the difference.

Some Republican­s say restoring the federal payments would give insurers a windfall.

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