A proposal to fund a $10 billion-per-year reinsurance pool for state Obamacare markets hit partisan gridlock in a U.S. House of Representatives hearing Wednesday.
Representatives in the House Energy and Commerce Committee's health panel clashed over adding anti-abortion language to the reinsurance bill and disagreed over the proposal's scope. It's a significant request from the insurance industry this year, and now faces a tough road ahead.
Energy and Commerce Chair Frank Pallone (D-N.J.) told his colleagues that the Democratic proposal from Reps. Angie Craig (D-Minn.) and Scott Peters (D-Calif.) was "modeled after the reinsurance program that all the Republicans on this committee supported in the (Affordable Care Act) repeal bill."
The first stumbling block was partisan disagreement over whether to include anti-abortion language, known as the Hyde Amendment, with the measure. The amendment would ban any federal funds from paying for abortion.
A bipartisan deal to fund reinsurance and cost-sharing reduction payments failed last year when Democrats and Republicans couldn't agree about including this language with the CSR appropriation.
But Republicans also criticized the scope of the reinsurance bill, signaling trouble to come if insurers hope the GOP-majority Senate will take up similar legislation.
Energy and Commerce health panel Ranking Member Rep. Michael Burgess (R-Texas) said the measure "does not provide states with adequate flexibility to use the funds."
Rep. Fred Upton (R-Mich.) questioned whether the fund was necessary in light of the ACA's 1332 State Innovation waivers that can be used to set up reinsurance programs using pass-through funding from the federal government.
Lawmakers on both sides of the aisle agreed ACA individual market premiums are too high for people without subsidies.
"The middle class has taken a hit, there is no doubt about that, and that is unacceptable," health committee Chair Anna Eshoo (D-Calif.) said.
Burgess decried state silver-loading — where insurers add the cost-sharing reduction payment costs into the silver exchange plans — as raising premiums on the middle class.
Silver-loading is a result of the Trump administration's cut-off to CSRs. The CMS has asked stakeholders to weigh in on whether silver-loading should continue after 2020. Industry has overwhelmingly petitioned the agency not to ban silver-loading.
Wednesday's hearing was the panel's second discussion of Democratic legislation to boost Obamacare ahead of 2020.
In addition to reinsurance, lawmakers mulled bills to boost marketing and outreach money for ACA navigators as well as funnel $200 million for states to set up their own health exchanges in lieu of the CMS' Healthcare.gov marketplace.