After failing to repeal Obamacare earlier this year, Republicans are now getting close to an unexpected “B” word when it comes to health care: bipartisanship.
Back in Washington after a five-week summer recess, GOP lawmakers are further this week than they’ve ever been from succeeding in their years-long campaign promise of dismantling the Affordable Care Act, President Barack Obama’s signature domestic legislation. Even more striking: the packed congressional agenda this week includes, for the first time this Congress, bipartisan committee hearings on potential fixes to the health care law.
The Senate health committee will hold back-to-back hearings on Wednesday and Thursday with the goal of “stabilizing premiums and helping individuals in the individual insurance market.” The first day will feature state insurance commissions as witnesses, and on Day Two, governors hailing from five states will testify.
In a year that has been consumed by partisan efforts by Republicans to gut Obamacare, the party may also be running out of time.
Last week, Sen. Bernie Sanders, a liberal from Vermont, said in a statement that according to the Senate parliamentarian, the Senate’s 2017 budget resolution — the vehicle that Republicans have been using all year to try to repeal Obamacare with just a 51-simple majority vote — will expire at the end of the month. In other words, Sanders said, the window for Obamacare repeal is quickly closing.
While congressional Democrats have tried to shield Obamacare from the GOP campaign to repeal the law, many have also acknowledged that Obama’s legacy accomplishment is in urgent need of improvements.
Over the August recess, aides to the Senate health committee’s top Republican and Democrat, Sens. Lamar Alexander and Patty Murray, were in frequent contact to discuss legislation that could ultimately result from this month’s hearings, according to a Democratic aide. Democrats want to see a bill that guarantees payments for a key Obamacare subsidy for more than a year, that aide added.
The two senators are also looking for ways to strengthen the individual mandate so that young, healthier people stay in the marketplace, as well setting up some kind of reinsurance program to cover the cost of requiring insurers to cover those with pre-existing conditions. They also want to try to lower premiums for the roughly 9 million people who get no help buying coverage in the individual market.
This comes as insurance companies and industry leaders have raised concerns about President Donald Trump skirting the question of whether it will make those cost-sharing reduction payments.
While Trump did recently agree to make the August payment, it’s unclear what he will do with future payments — uncertainty that has made insurers jittery and led some to raise premiums or even flee the marketplace altogether. The next payment is expected to go out September 20.
According to the Congressional Budget Office, insurers would hike premiums on Obamacare silver plans by 20% and the number of uninsured would rise next year if Trump stops the funding.
But the committee’s efforts may come too late for health insurers. The deadline to sign 2018 contracts is September 27. The industry has asked lawmakers and the White House for months — if not years — for the very stability measure the committee is now considering. With so much uncertainty and chaos emanating from Washington this year, many carriers opted to downsize or exit the Obamacare exchanges for 2018.
Alexander’s biggest concern — that many Americans would have no insurers offering policies on their Obamacare exchanges — has been alleviated. While at one point, about 92,000 people in more than 80 counties across the nation were at risk of having no options for 2018, other carriers stepped in to provide coverage.
The lead-up to the hearings has already been an exercise in bipartisanship. The committee’s chairman, Alexander, had full discretion over the witness list but invited a mix of Republican and Democratic voices.
Montana Gov. Steve Bullock, a Democrat, is scheduled to be a witness alongside Utah Gov. Gary Herbert, a Republican, on Thursday. Also scheduled to testify are Republican Govs. Charlie Baker of Massachusetts and Tennessee Gov. Bill Haslam and Democratic Gov. John Hickenlooper of Colorado.
The bipartisan approach comes after a fits-and-starts effort to repeal Obamacare was unsuccessful. With no signs that the votes in the Senate will change, working with Democrats appears to be the only viable option for Republicans at this point.
Both Republicans and Democrats are motivated to do something. Despite the fact that the Affordable Care Act was Obama’s signature accomplishment, many Democrats from red states see an opportunity to bring down Obamacare premiums and expand options for people in rural areas. Many of those same red state Democratic senators will face re-election in 2018.
Republicans, on the other hand, recognize they are the ones with the burden to fix an imperfect system now that they have control of the House, the Senate and the White House. Failing to do so could result in major losses in the upcoming midterms.
Alexander and Murray also have a long history of working together on major legislation. The two senators forged a relationship to pass the 21st Century Cures Act. They also worked closely to dismantle No Child Left Behind, another politically divisive issue.
“It is clearer than ever that the path to continue making health care work better for patients and families isn’t through partisanship or backroom deals,” Murray said in a statement. “It is through working across the aisle, transparency, and coming together to find common ground where we can.”