As Senate Republican leaders canceled their accustomed monthlong August recess, Democrats said they would force healthcare votes, considered their party's winning issue for contentious midterm elections where 24 Democratic Senate seats are in play.
Senate Minority Leader Charles Schumer (D-N.Y.) vowed to try to force votes on a swath of policies that go far beyond the stabilization package that was under negotiation earlier this year. These include Medicare buy-in for people aged 55 and up, beefing up tax credits available for families on the Obamacare exchanges, establishing a national reinsurance program, regulating insurance that doesn't comply with Obamacare for people with pre-existing conditions and imposing measures to lower drug prices.
Schumer and other leading Democrats blasted congressional Republicans and the White House for expanding short-term health plans and association health plans and cutting off the cost-sharing reduction payments for low-income exchange enrollees, as well as effectively eliminating the individual mandate. The Democrats said the policies directly caused the soaring insurance rates recently proposed for the exchanges in states like Maryland and Virginia.
"We want to reverse those policies that hurt the middle class," Schumer told reporters on Tuesday. "Middle-class families will have their pockets picked with the aid and help of our Republican friends in the House and Senate."
Not all states are seeing equally high rate increases. This week, Maine and Pennsylvania's Obamacare carriers proposed smaller increases—just over 9% in Maine and about 4.9% in Pennsylvania.
Insurance actuaries and the Congressional Budget Office have blamed the zeroing out of the individual mandate penalty for much of the rate hikes, although some insurers have conceded that as rates continued to climb the penalty didn't have the teeth to drive younger and healthier people into the exchanges as the law originally intended.
When McConnell announced the abbreviated recess, he said the Senate would focus on judicial nominations and appropriations bills, as well as an opioids package and measures including the National Defense Authorization Act, water infrastructure and the farm bill that is currently stalled in the House in a version that the Senate isn't likely to pass.
Schumer downplayed the need for extra time for the appropriations process, saying that it is moving along quickly and both parties are working well together.
Schumer said the Democrats have legislation ready to go on the healthcare policies he outlined through the party's blueprint called "A Better Deal" unveiled earlier this year, but did not reference the stabilization package Senate health committee leaders Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) began negotiating last fall before the last failed GOP attempt to repeal Obamacare with the Graham-Cassidy bill.
Murray told Modern Healthcare that she remains open to stabilization if she and Alexander could go back to the original agreement, but she named drug price negotiations in Medicare as a top priority.
"What they threw out at the end was a partisan bill with poison pills in it, and that's why it didn't get passed," Murray said.
Negotiations broke down after Republicans and the White House pushed hard to add abortion prohibitions to cost-sharing reduction payments, so that for anyone getting CSRs her insurance couldn't cover abortion.
Democrats ended up blocking a stabilization package led by Alexander and Sen. Susan Collins (R-Maine) from being included in the March spending omnibus bill.
Schumer did not mention funding of cost-sharing reduction payments as one of the agenda items. Some Democrats and left-leaning analysts have lost interest in restoring their funding since most states started loading the costs into silver exchange plans used as the benchmark to calculate subsidies for low-income enrollees. While silver-loading has raised premiums substantially for people who make more than 400% of the poverty level, subsidies have gone up for those with lower incomes.
Healthcare is a winning issue for Democrats and tops voters' priority lists nationwide. Still, canceling the recess will keep vulnerable Democratic candidates from the campaign trail in the lead-up to tight midterm races.
However, Sen. Claire McCaskill (R-Mo.), one of the GOP's top targets, said she isn't worried and took the opportunity to talk about drug pricing—a key issue for her.
"The perfect thing to tackle in August is to get after pharmaceutical companies," McCaskill said.
She emphasized bipartisan bills that could "help with premium increaes on exchanges."
"This is the perfect time to do that," McCaskill said. "I'm hopeful that's why (McConnell) is doing that."