A pair of U.S. senators is scrambling to shore up the Obamacare insurance markets, an effort made especially urgent by a series of moves by the Trump administration. On Tuesday they revealed the outlines of a compromise, including an agreement to restore about $7 billion in annual payments to health insurers that the administration recently halted.
These payments reimbursed insurers for the discounts they gave low-income consumers not covered by large employer health plans to help them with out-of-pocket costs. Without them, insurers are expected to increase premiums for millions of other customers without employer health benefits — or worse, to stop selling policies on the Obamacare exchanges. The impact is expected to be felt most strongly in red states, where most of the people receiving out-of-pocket discounts live.
Backers of the compromise face at least one hurdle, though: Many Republican lawmakers have blasted the reimbursements as a “bailout” for insurers, even though the Affordable Care Act mandated that insurers provide the discounts and that the federal government cover the cost.
Unless they want to add roughly 20% to the insurance premiums faced by millions of their constituents, Republicans ought to work with Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), whose draft proposal would fund the reimbursements for two years. To further placate Republicans, the proposal would give them something they’ve sought all year: more freedom under the ACA for healthier people to buy cheaper, less comprehensive insurance policies.
The details of the bill were still being finalized Tuesday, so a number of lawmakers on both sides of the aisle withheld judgments. Others, however, simply would not countenance making the reimbursements — once a bailout, always a bailout. For example, Rep. Mark Walker (R-N.C.), who leads a group of House conservatives, tweeted, “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”
If it’s a bailout when Congress decides to keep making a payment it has obligated itself by law to pay, then every dollar spent to arm the military is a bailout for defense contractors. The word was chosen not because it’s grounded in reality, but because it riles the public.
Again, if the reimbursements end, the cost will simply be passed on to those who aren’t covered by employer health plans in the form of higher premiums. If that’s what Republicans want for their constituents, so be it. If not, they need to drop the “bailout” fiction and start working to restore the reimbursements.
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