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February 27, 2019 04:17 PM

Moderate Democrats revive talks to fund CSRs, reinsurance

Susannah Luthi
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    AP

    Centrist House Democrats on Wednesday launched a push to revive Obamacare stabilization talks, two hours after their progressive wing unveiled new Medicare for All legislation.

    The 101-strong New Democrat Coalition wants to fund reinsurance and cost-sharing reduction payments in a package that closely resembles the deal struck last Congress by Senate health committee leaders Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.).

    That bill, known colloquially as Alexander-Murray, fell apart at the last minute following a GOP-Democratic dispute over including anti-abortion language.

    "Well, we would call it Schrader-Bera-Kuster," joked Rep. Kurt Schrader (D-Ore.), one of the co-chairs of the coalition's healthcare task force as he referred to fellow co-chairs Reps. Ami Bera (D-Calif.) and Annie Kuster (D-N.H.).

    He said the group wants to take another run at it, as this is a "different Congress, with a different makeup," and voters gave Congress a mandate to make the individual market more affordable.

    To prod leadership into action, the group sent a letter urging prompt committee action to key committee leaders—Frank Pallone (D-N.J.) of Energy and Commerce, Chair Richard Neal (D-Mass.) of Ways and Means, and Bobby Scott (D-Va.) of Education and Labor.

    "Building upon your work and the work of the New Democrat Coalition last Congress, we urge your committees to deliver on the promises made to our constituents by prioritizing strengthening the ACA and continuing the path toward universal affordable coverage," the group wrote.

    The group hopes numbers are on their side. It's now the largest ideological caucus in Congress and owes its swelling ranks to the 40 Democratic freshmen who swept into office largely with the ACA on their platform.

    The coalition announced its healthcare policy wish list two hours after progressive Democrats' 70-minute press conference unveiling the new Medicare for All or single payer legislation.

    Coalition members downplayed their role as opposing single payer—highlighting instead the pragmatism of lowering ACA individual market premiums as action Congress can take immediately for people who remain unsubsidized.

    They also said they want to discuss public options, such as a policy to allow people to buy into Medicare or Medicaid.

    Democratic leaders have pushed support for the ACA as a key part of their agenda, but proposals so far this Congress haven't included funding for CSRs—whose cut-off led to the silver-loading that boosts premiums for people who can't get subsidies—or reinsurance.

    The Pallone-Neal-Scott proposal from last year includes reinsurance and CSRs, but enthusiasm for funding CSRs has waned since last year. Liberal advocates like the fact that the CSR cut-off led to bigger subsidies for low-income people.

    And while insurers hope stabilization talks resurface, their profitability on the exchanges is soaring.

    On Wednesday, Pallone told an audience at an Atlantic Live event that he's most interested in growing the subsidies—increasing the pool of people who qualify for them and raising what's available for people who currently receive them.

    "It's clear now that people at the higher income level, who were not eligible for those subsidies before, that we need to raise that, for people with a higher income, because there are people now making over $85, $90k a year who don't get any subsidy," Pallone said Wednesday morning. "In a place like New Jersey, that's not a lot of income for a family of four."

    He also confirmed that the House will push back against the Trump administration's expansion of short-term, limited duration plans.

    Pallone was pressed on the cost problem: that an increase in subsidies puts the government on the hook for most of the high premiums, he pointed to his proposal to set up a reinsurance pool.

    On whether Congress could overcome last year's dispute over abortion language, Schrader was optimistic.

    However, a Republican aide for the Senate health committee responded by referring to a comment made to Modern Healthcare last week.

    "The only way Congress could pass an appropriation for CSRs is if Democrats reverse course and agree to apply the Hyde Amendment which applies to all other healthcare appropriations," the staffer said.

    Correction: The original story incorrectly stated that the Pallone-Neal-Scott bill did not fund CSRs. This error has been corrected.

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