Senators say they’ve reached deal on ACA insurer subsidies

Sens. Lamar Alexander, R-Tennessee and Patty Murray, D-Washington, have told reporters they’ve reached an agreement to fund the Affordable Care Act’s cost-sharing reduction subsidies to insurers which had been halted by President Donald Trump.

Alexander, the chairman of the Senate’s health committee, has been working with Murray, the committee’s ranking Democrat, on a deal which would involve guaranteeing funding for the subsidies, known as CSRs, for two years in exchange for states having additional “flexibility” on waiving certain ACA requirements.

This would involve allowing all ACA exchange customers, not just those under 30, to sign up for lower-premium, high-deductible catastrophic plans. Additionally, the language governing ACA waivers, known as 1332s, would change: Instead of being limited to changes which make insurance plans “as affordable as” existing exchange plans, states could approve plans which offer “comparable” affordability. HHS would be required to offer “model” waiver plans to speed up the approval process for states.

ABC News reported there would be an additional win for Democrats in the deal: $160 million to restore funding for outreach and navigator programs cut by Trump ahead of the upcoming open enrollment period.

A draft of the legislation obtained by Axios said there would be a mechanism to prevent insurance companies from profiting off premium increases requested when the CSRs were in doubt. State insurance regulators would need to certify with HHS that states will pass on CSR funds to enrollees or the federal government.

Senate Minority Leader Chuck Schumer, D-New York, said the agreement would “undo” what he calls “sabotage” of the ACA by the Trump administration and promised the deal would have “broad support” among his caucus. Trump himself indicated he’d support the deal during a press conference at the White House, calling it a “short-term solution.”

Hours later, however, he was more critical of CSRs in a speech to the conservative Heritage Foundation.

“While I commend the bipartisan work done by Senators Alexander and Murray—and I do commend it—I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies,” he said.

The legislation may find opposition among more conservative Republicans on Capitol Hill, especially in the House. Rep. Mark Walker, R-North Carolina, indicated he’d oppose a deal he sees as “propping up” the ACA.

“The GOP should focus on repealing and replacing Obamacare, not trying to save it,” Walker said, according to POLITICO. “This bailout is unacceptable.”