Senate GOP short on ideas for stabilizing ObamaCare markets

Senate Republicans are floating a short-term fix to stabilize the ObamaCare insurance markets before next year.

Health insurance plans across the country need to decide by next month whether they will continue to operate in the ObamaCare exchanges, creating an immediate deadline for Congress. The Senate is unlikely to have completed its legislation to repeal the healthcare law by then, so lawmakers are casting about for ways to quickly strengthen the marketplaces.

Senators are meeting three times a week to discuss how best to craft legislation to repeal and replace ObamaCare in the wake of the House-passed bill. They are under pressure to shore up the markets but see no easy solutions.

{mosads}Sen. Ron Johnson (R-Wis.) told reporters this week that a short-term solution may be needed in order to give senators more time to work on the larger repeal bill.

“The question is, do we separate it out, do something quick, maybe ask for Democratic support on that, or do we just try to come to conclusion on an overall bill?” Johnson said. “We’re trying to grapple what can we do short term to stabilize these markets to prevent them collapsing, see if we can stabilize these insurance rates at least for 2018.”

“We’re running out of time.”

Any short-term solution would likely require Democratic support — which hasn’t been forthcoming so far.

Some members have been engaging in bipartisan talks, but Democrats have made it clear they won’t work with Republicans unless they stop trying to repeal ObamaCare.  

Tennessee Republican Sens. Lamar Alexander and Bob Corker proposed legislation that would allow people to use their ObamaCare subsidies to purchase any state-approved plan on the private market if there are no insurers selling policies on the federal exchange in their county.

But Democrats say that proposal would actually make the problem worse and would encourage more insurers to drop out of the marketplaces.  

As a counter to their proposal, Sen. Claire McCaskill (D-Mo.) introduced legislation Thursday that would allow people who live in “bare counties” without ObamaCare insurers to buy coverage on the D.C. exchange, where most members of Congress and congressional staff purchase insurance.

It would be easier for Republicans to pass just one bill, which could include an ObamaCare repeal as well as elements of the Alexander-Corker plan. But Senate Republicans can’t agree on many of the elements of an ObamaCare repeal, let alone a short-term market stabilization effort.

“We’re talking about how you keep the insurance companies in the exchanges until you get the new plan in place,” Sen. John Hoeven (R-N.D.) said. “So we haven’t taken anything off the table yet. We can still give that assurance if we come up with something that works.”

Insurance plans are already planning large premium hikes for the ObamaCare exchanges or are completely exiting the marketplaces amid growing uncertainty over the future of the law and mounting financial losses.

“We have to get something in place so insurance companies can look at it,” Sen. Thom Tillis (R-N.C.) said. “We need to look at what the potential bridge timeframe looks like. There may need to be some relief.”

The Trump administration and congressional Republicans have seized on the premium increases and marketplace exits as proof that ObamaCare is failing, while Democrats blame the administration for creating such an uncertain environment.

While both sides point fingers, people across the country are feeling the impact of their uncertainty.

Some states could see premium increases of 50 percent or more next year.

Cynthia Cox, an insurance expert with the Kaiser Family Foundation, said Congress’s options to stabilize the insurance markets for next year are pretty limited.

“Any legislative changes that would require implementation realistically is kind of too late,” Cox said.

There have been mixed signals from the Trump administration about shoring up the exchanges. The Department of Health and Human Services released an insurer-friendly rule to try to coax companies into staying in the market.

But at the same time, senior administration officials — and President Trump himself — have repeatedly threatened to cut off cost-sharing reduction (CSR) subsidies to insurers.

Insurance companies rely on the payments, and many have said they will be forced to raise premiums or leave the ObamaCare marketplace if the payments don’t continue.

Cox said Congress funding the CSRs would be “probably the most simple, obvious thing” to ease uncertainty in the markets.

But Congress declined to fund the subsidies in its year-end spending bill and instead chose to let the administration continue to make the payments.

— Jessie Hellmann contributed.