Republicans and Democrats serenely discussed ways to curb premium increases for individual insurance policies on Wednesday at a Senate hearing that veered away from years of fierce partisanship over the failed GOP effort to revoke President Barack Obama's health care law.
Continue Reading Below
Senators and state insurance commissioners from both parties embraced the idea of continuing billions in federal subsidies to insurers for reducing out-of-pocket expenses for millions of people, flouting President Donald Trump's oft-repeated threats to halt those payments. There were even bipartisan words of support for proposals to provide money to states to help insurance companies afford to cover customers with serious, costly medical conditions.
Disagreements remain, including over Republican demands to also make it easier for insurers to sell policies that might offer skimpier coverage than Obama's statute allows. But if nothing else, the Senate health committee hearing underscored both sides' willingness to try casting aside hostility from the GOP drive to repeal Obama's 2010 law and seek a modest pact that would instead bolster that statute by protecting the affordability of constituents' coverage.
"I think we did a pretty good job today of not blaming each other," panel Chairman Lamar Alexander, R-Tenn., said afterward.
The harmony came at the first of four health committee hearings on how to shore up the individual insurance marketplace, where about 18 million people buy policies who don't get coverage at work or from the government. Insurance commissioners from five states testified Wednesday, and five governors were slated to appear Thursday.
Alexander said he wants to produce a bipartisan bill by the end of next week. By late September, insurers must decide whether to sell policies in the government's Healthcare.gov online exchanges in 2018. Alexander and top panel Democrat Patty Murray of Washington state hope to produce a bill before that deadline to ease companies' anxieties.
"Threading this needle won't be easy," Murray said during the hearing. She later told reporters she was "very hopeful" the two sides could reach agreement on a measure.
While the hearing's prevailing mood was harmonious, some comments underscored party differences.
Conservative Sen. Rand Paul, R-Ky., said the individual insurance market is "non-functional" and said lawmakers should let those customers join more efficient group plans. He called federal payments to insurers "a scam."
Liberal Sen. Elizabeth Warren, D-Mass., said Trump is trying to "sabotage" health care by threatening to end the payments to insurers and slashing money for federal attempts to persuade people to buy policies. Trump's effort is "petty and it's going to hurt millions of people," she said.
Alexander has proposed providing the payments to insurers for a year, though Democrats want it extended two years or more. Alexander suggested flexibility, saying, "We can discuss what that time is."
Obama's law requires insurers to lower deductibles and other out-of-pocket costs for lower-earning people, and obliges the government to reimburse the companies. A federal court has said Congress didn't legally provide that money, and Trump has threatened to block the payments, calling them a bailout.
Members of both parties are resisting Trump. They cite expectations by insurance companies and the nonpartisan Congressional Budget Office that stopping the subsidies would boost premiums 20 percent above expected increases, and prompt some insurers to flee marketplaces.
Halting those payments would make individual markets "worse off, certainly," said Julie Mix McPeak, Tennessee's insurance commissioner.
In exchange for the money, Alexander wants to make it easier for states to get federal waivers for insurers to sell policies that might not meet Obama coverage standards.
Without a deal, "The blame will be on every one of us, and deservedly so," Alexander said.
Democrats have shown no interest in weakening Obama's law. Murray said Democrats are willing to look at ways to simplify how states get waivers, which the insurance commissioners supported Wednesday, but would oppose weakening consumer protections.
"He understands that and we're working on solutions," Murray said of Alexander.
Analysts expect 2018 premium increases to match or exceed the average 25 percent boosts on midlevel plans sold this year on Healthcare.gov. Insurers say additional upsurges are possible due to uncertainty over Trump administration actions.
Nearly half the nation's roughly 3,000 counties are expected to have only one insurer offering coverage on government insurance exchanges next year. Republicans say that lack of competition shows a failing of Obama's law.
Republicans also had asserted that a few mostly rural counties would have no insurers selling policies in 2018. The latest federal figures project that won't happen.