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The long-standing promise by Congressional Republicans to repeal the Affordable Care Act won votes, but when President Trump’s election made it possible to keep the promise it quickly was exposed as a cruel joke that would deprive millions of Americans of health insurance.
The defeat of a scaled-down repeal bill, which had been hatched out behind closed doors, now has set the stage for Tennessee Republican Sen. Lamar Alexander, chairman of the Health, Education, Labor and Pensions Committee, to lead a bipartisan health care reform effort that actually could help improve health care and make it more affordable.
Off and running in Washington last week, hearings organized by Alexander and Sen. Patty Murray (D-Wash.) are – in contrast with the secretive meetings held earlier this year – being conducted in the open, with bipartisan involvement and testimony from witnesses with the expertise and experience to guide Congress toward improvements in the current system.
Senator Lamar Alexander on why the health care clock is ticking
In his opening statement, Alexander proposed “that we come to a consensus by the end of next week when our hearings are complete so that Congress can act by the end of September.”
The Alexander-Murray initiative represents a welcome departure from demonizing, repealing and replacing the so-called Obamacare program to a more pragmatic path focused on how it could be made to work better for patients.
It follows the collapse over the summer of the GOP repeal campaign amid widespread criticism that the legislation would have stripped insurance protections from tens of millions of Americans.
With the end-of-September deadline looming for insurers to decide how much their premiums will cost next year, a short-term plan further strengthening and stabilizing the market is a committee priority.
Technically, the effort to repeal the ACA that excludes Democrats and the public is still in play, but, with the public solidly against that idea, the Alexander-Murray approach holds much more promise.
Keys to success, Alexander has said, include making sure that insurers understand they will continue to receive cost-sharing reduction payments, which subsidize out-of-pocket costs for certain consumers.
Without the payments, which total $7 billion in fiscal 2017, premium increases would accelerate and insurance companies most likely would start withdrawing their coverage county-by-county again, as they did in three Tennessee metro areas a year ago.
However, if the payments continue, Alexander maintains, insurers may be persuaded to re-file for lower 2018 premiums.
“Congress doesn’t do comprehensive well, and I think it makes much more sense to go step-by-step, especially since the last seven years have been so partisan,” Alexander said in an interview with The Tennessean. “If we can agree on a single, limited bipartisan step in September… then we could take second steps, and there are obvious steps.”
There is little time left to set those wheels in motion, but success could add considerable luster to Alexander’s legacy as a U.S. senator.
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