Congressional Republicans Offer Alternative to Bipartisan Health Care Reform Proposal; Judge Permits CSR Payment Halt

This week, Senate Finance Chairman Orrin Hatch and House Ways and Means Chairman Kevin Brady announced an agreement on alternate health care reform language they are drafting into legislation that would fund the Obamacare insurance subsidies through 2019 in exchange for temporarily eliminating the health law's individual mandate. These subsidies, known as cost-sharing reduction payments, or CSRs, were earlier halted by President Trump. The bill language is expected in the coming days.

Aspects of this proposal, including funding for the CSRs, are similar to those included in a bipartisan bill introduced by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) earlier in October. However, there are several differences, including elimination of the Affordable Care Act’s controversial individual mandate through 2021, expansion of health savings accounts, exempting businesses from the employer mandate for 2015 through 2017, and applying certain abortion restrictions to the CSR funding. It is not yet known how their colleagues in Congress or the Administration will respond to this latest proposal.

Meanwhile, the Congressional Budget Office has released an estimate of the effects of the Alexander Murray bipartisan proposal. The CBO analysis projects the bipartisan bill would shave $3.8 billion off the deficit, while having little to no effect on the number of people insured nationwide. This is in contrast to other estimates the CBO has provided on other reform efforts, which all left millions without coverage.

Finally, yesterday, a federal judge decided the Trump Administration is not required to fund the CSRs while the full matter is heard by the court. The state of California, along with other states, had petitioned the court to require the Administration to continue making the payments while the case ran its course. The judge believes the interested parties have shielded themselves from immediate harm, making their request moot. The judge expects the case to be decided before the end of 2018.

ASA physician leaders and staff will continue to provide updates to members on the state of health care reform.