Alexander-Murray Stabilization Package Introduced Cont.

Despite his recent cancellation of CSR payments, in addition to the recent signing of an executive order to dismantle other parts of the ACA, President Trump initially appeared to take credit for encouraging the bipartisan negotiations in the Senate, adding that his Administration had been involved in drafting the proposal. He later walked back his initial statements, saying that he would consider the bipartisan proposal, but never be able to support a “bail out” of insurance companies. Director of the Office of Management and Budget (OMB) Mick Mulvaney has offered an alternative take from the Administration on the agreement, saying that the President supports “some type” of short-term deal to stabilize the individual market that goes beyond simple extension of CSR payments and that could be packaged as some sort of larger deal. Other staff within the Administration have suggested that elimination of the individual and employer mandates is the only acceptable starting point for restoring the CSR payments and passing a bipartisan deal. The President has also demanded that language be added to ensure that CSRs work to the benefit of consumers, not insurance companies.

Despite concerns from some lawmakers that the proposal had stalled out only days after its announcement, the bill was introduced on Thursday with the backing of 24 senators with equal support from both parties. Republican cosponsors include Sens. Mike Rounds (R-S.D.), Lindsey Graham (R-S.C.), John McCain (R-Ariz.), Bill Cassidy (R-La.), Susan Collins (R-Maine), Joni Ernst (R-Iowa), Lisa Murkowski (R-Alaska), Charles Grassley (R-Iowa), Johnny Isakson (R-Ga.), Richard Burr (R-N.C.) and Bob Corker (R-Tenn.). Democratic cosponsors include Sens. Al Franken (D-Minn.), Jeanne Shaheen (D-N.H.), Joe Donnelly (D-Ind.), Amy Klobuchar (D-Minn.), Maggie Hassan (D-N.H.), Claire McCaskill (D-Mo.), Heidi Heitkamp (D-N.D.), Joe Manchin (D-W.V.), Tom Carper (D-Del.), Tammy Baldwin (D-Wis.) and Angus King (Maine), an independent who caucuses with the Democrats. Sen. Schumer (D-NY) has stated that all of the members of the Democratic Caucus would vote for the legislation (total of 48 members). Coupled with the twelve GOP cosponsors at introduction, the bill has 60 votes for passage.

Senate Finance Committee Chairman Orrin Hatch has unequivocally opposed the deal, while Majority Leader Mitch McConnell (R-Ky.) has been tight-lipped, saying that the path forward for the legislation is unclear. On Sunday, Senate Majority Leader Mitch McConnell says he’s willing to bring bipartisan health care legislation to the floor if President Donald Trump makes clear he supports it. McConnell tells CNNs’ “State of the Union” he’s “waiting” to hear from Trump “what kind of health care bill he might sign. . I think he hasn’t made a final decision. When he does, and I know we’re not just debating it, but actually passing something to be signed, I’d be happy to bring it up.” While there is still no guarantee that the plan will be considered on the Senate floor, it is even less likely that the House will vote on the agreement. Speaker of the House Paul Ryan (R-Wis.) has rejected the deal, urging the Senate to keep its focus on repealing and replacing Obamacare. Chairman of the conservative Republican Study Committee Mark Walker (R-N.C.) is also opposed to the plan, arguing that it props up a law that Republicans promised to dismantle. Freedom Caucus Chairman Mark Meadows (R-N.C.) did not dismiss the plan outright, calling it a “good start,” but noting that much more work would need to be done to consider the proposal.

A number of Republican senators have acknowledged that the stabilization package requires some changes in order to address concerns of the House GOP. Sens. Graham, Cassidy, and Ron Johnson (R-Wis.) are working to include additional flexibility provisions like those contained in their ACA repeal legislation in order to “lay the groundwork” for
longer-term reform. Sen. Alexander has said that he is open to such changes, but Senate Democrats are likely to reject any congressional or administrative efforts to amend the bill.

The Senate already has a full legislative calendar, with a defense authorization bill, the GOP budget resolution, reauthorization of the Children’s Health Insurance Program (CHIP), and tax reform high on the agenda. The agreement’s greatest chance of passage appears to be if it is included as a part of a larger package of must-pass legislation, such as the omnibus spending bill or disaster relief efforts, which might not be considered until the end of the year. Regardless, the deal will require 60 votes in the Senate for passage.

America’s Health Insurance Plans (AHIP) and the American Medical Association (AMA) have both endorsed the bipartisan plan to shore up the individual insurance market – arguing that it will lead to more choice and more affordable care. Open enrollment for Americans to begin signing up for 2018 coverage begins on November 1 and ends on December 15.

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