Now that the ACA survived the August repeal and replace efforts, what comes next? Many in Congress are committed to bipartisan solutions to the instability in the ACA marketplaces and on the individual markets, and negotiations are underway.
Senator Lamar Alexander (R-TN), chair of the Senate Health, Education, Labor and Pension (HELP) committee, has expressed a need to quickly fix those problems. That committee has prominent Senators from all across the healthcare spectrum, including Bernie Sanders, Elizabeth Warren, Tim Kaine, Lisa Murkowski, Susan Collins, Bill Cassidy and Rand Paul. It is difficult to imagine that Cassidy and Paul are willing to do anything to help the ACA, even in the short term. In the House, the bipartisan Problem Solvers Caucus has been in contact with the Senate and a broad agreement seems to be coalescing around 4 fixes:
- Making the Cost Sharing Reduction (CSR) payments;
- Repealing the mandate for employers with fewer than 500 employees;
- Repealing the medical device tax; and
- Promoting flexibility for states through the use of waivers.
However, the President, Senator Cassidy and the Freedom Caucus remain committed to repealing the ACA. Trump continues to threaten to withhold CSR payments to insurers. Without a firm commitment to CSRs and uncertainty regarding the individual mandate, insurers continue to withdraw from markets and premiums for 2018 are skyrocketing. Most individuals will be shielded from the full force of the increased premiums as they receive subsidies. Not so for middle and upper middle class Americans, who will be paying substantially more in 2018 for the same level of coverage as in 2018. Click here for KFF article.
A large majority of Americans (78%) think the President and his administration should make the current health law work. A majority (60%) want bipartisan solutions to improve it. click here for KFF poll.
Congress reconvenes in early September.