House GOP warming to ObamaCare fix

Key House Republicans are warming to a proposal aimed at bringing down ObamaCare premiums, raising the chances of legislative action this year to stabilize the health-care law.

House GOP aides and lobbyists say that top House Republicans are interested in funding what is known as reinsurance. The money could be included in a coming bipartisan government funding deal or in another legislative vehicle.

Any action from Republicans to stabilize ObamaCare would be a major departure from the party’s long crusade against the law, but after having failed to repeal the Affordable Care Act last year, the discussion is shifting.

{mosads}Rep. Ryan Costello (R-Pa.) is one of the leaders of the push in the House and is sponsoring a bill to provide ObamaCare stability funding in 2019 and 2020. He notes the relatively short-term nature of his measure. 

“That reflects the political reality that we are not going to be doing some large, sweeping health-care bill in the next year,” said Costello, who faces a competitive reelection race this year. 

“I am optimistic that it would be under serious consideration for inclusion in the omnibus,” he added.  

Speaker Paul Ryan (R-Wis.) noted the possibility of action on an ObamaCare stability measure, particularly funding for reinsurance, at an event in Wisconsin in January, saying he thought there could be a “bipartisan opportunity” on the issue.

Action on the reinsurance payments is far from certain; conservative opposition to what some view as a bailout of ObamaCare insurers could stop the proposal in its tracks. But there is growing momentum for the idea, and Republicans said the proposal would likely be discussed more at the GOP retreat this week in West Virginia.

The push on reinsurance matches up with one of the ObamaCare bills that Sen. Susan Collins (R-Maine) has been pushing in the Senate.

Senate Majority Leader Mitch McConnell (R-Ky.) gave Collins a commitment to support a reinsurance bill as well as another stability measure from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) in exchange for Collins’s support for tax reform in December.

Opposition in the House has always been the major impediment to those measures moving forward. But it now appears some of that resistance is softening, at least on the reinsurance measure, now that Republicans have repealed ObamaCare’s individual mandate through the tax bill.

Importantly, House Energy and Commerce Committee Chairman Greg Walden (R-Ore.), whose panel has jurisdiction, is supporting the ObamaCare stabilization efforts and backs Costello’s bill.

“Chairman Walden is supportive of Rep. Costello’s efforts to help states repair their insurance markets that have been damaged by Obamacare,” an Energy and Commerce spokesperson wrote in an email. “Rep. Costello’s bill is a fair approach to granting states greater flexibility to help patients and lower costs.”

Rep. Cathy McMorris Rodgers (R-Wash.), the fourth-ranking Republican in House leadership, is also a co-sponsor of Costello’s stabilization bill. 

While House conservatives have opposed propping up ObamaCare, Rep. Mark Meadows (R-N.C.) did not dismiss the payments out of hand on Tuesday.

“If it lowers premiums, I’m willing to listen to any ideas,” said Meadows, who is chairman of the House Freedom Caucus.

He warned that he did not want a proposal to be an “insurance bailout,” but noted that he has been talking to colleagues in the House and Senate about the issue.   

Another obstacle for an ObamaCare fix is a dispute over abortion. Republicans are adamant that a stabilization measure must include restrictions on the new funding being used to cover abortion services, a notion that is problematic for Democrats. 

Reinsurance funding is used to help insurers cover the costs of especially sick patients, which helps relieve pressure on premiums for the broader group of enrollees.

The other main stabilization measure, from Alexander and Murray, would fund ObamaCare payments that reimburse insurers for giving discounts to low-income enrollees, known as cost-sharing reductions (CSRs).

Republican sources say there is less momentum in the House for funding CSRs than there is for the reinsurance measure. But even some Democrats are now questioning whether funding CSRs still makes sense, given that through a quirk in the law, President Trump’s cancellation of the payments last year actually led to increased subsidies and lower premiums for many enrollees.

Rep. Phil Roe (R-Tenn.), for example, a leading House Republican on health-care issues as co-chairman of the GOP Doctors Caucus, said Tuesday that he feels negatively about the idea of funding CSRs but likes the idea of reinsurance. 

Roe pushed back on the idea that the funding would be propping up ObamaCare, saying that the repeal of the individual mandate had changed the discussion because people no longer were forced to buy coverage.

Roe said he runs into people in his district paying more than $1,000 per month in premium costs.

“We’re going to have to do something,” he said.