ACA bills for reinsurance, insurer subsidies won’t be considered this year

After previously saying she had secured a commitment to pass the legislation by the end of 2017, Sen. Susan Collins, R-Maine, said bills to fund the Affordable Care Act (ACA)’s cost-sharing reduction subsidies and provide $5 billion in reinsurance will be left out of a year-end spending package.

Collins had emphasized the importance of passing those bills to mitigate the impact of repealing the ACA’s individual mandate as part of the Republican tax cut plan. The Congressional Budget Office had estimated the loss of the mandate, a key component of the ACA to encourage younger, healthier customers to enter the risk pool, would cause 13 million more to be uninsured by 2027 and increase premiums by 10 percent.

The two bills Collins supported, however, were shown to make up for those coverage losses and premiums hikes in an analysis by Avalere Health.

Collins, in a joint statement with Senate health committee chairman Lamar Alexander, R-Tennessee, said they asked Senate Majority Leader Mitch McConnell, R-Kentucky, to table the legislation so another short-term spending package can pass to avert a government shutdown.

“It looks like the Christmas present of lower health insurance premiums will now have to be a Valentine’s Day present,” Alexander said in a statement. “It is hard to add our bills to a year-end package that does not yet exist.”

That package could include another major healthcare priority: a reauthorization of the Children’s Health Insurance Program (CHIP). Collins said House Speaker Paul Ryan “remains committed” to passing the ACA bills, adding more reinsurance funding could be made available in 2018.

“There is every reason to believe that these important provisions can and will be delivered as part of a bipartisan agreement. And Majority Leader McConnell has told us that he will uphold his commitment to schedule and support the legislation,” Collins and Alexander said.

A White House spokesperson later said President Donald Trump still supports the passage of both bills.

Conservatives in the House, however, have remain opposed to the legislation, particularly the cost-sharing reduction subsidies, which they have labeled “bailouts” for insurance companies. In comments to the National Journal, Rep. Mark Walker, R-North Carolina, said McConnell’s promise to pass the legislation “means squat” in the House. Rep. Tom Cole, R-Oklahoma, implied Collins’ past opposition to earlier repeal-and-replace efforts also factor into conservatives’ stances on the bill.

“The person who’s asking this of us did not help us in the repeal of Obamacare, so why would we make this concession?” Cole said of Collins.