Following the failure to advance a comprehensive repeal and replace package to overhaul the healthcare system, key legislators in Congress have continued working to develop a narrower set of changes to stabilize the insurance markets. Most recently, the Chairman of the Senate Finance Committee, Senator Orrin Hatch (R-UT), and the Chairman of the Ways & Means Committee in the House, Congressman Kevin Brady (R-TX), released a bicameral proposal. The emphasis of the market stabilization discussion has been the reinstatement of cost-sharing reduction payments to lower premiums and promote overall stability. The aforementioned proposal includes funding for the payments through 2019, but also couples the payments with partisan policy riders (temporary elimination of the individual mandate, exemption from the employer mandate, and pro-life protections).
The recent action by Chairmen Hatch and Brady is viewed as a direct response to the recent release of the market stabilization proposal prepared by the Chairman of the Health, Education, Labor and Pensions (HELP) Committee, Senator Lamar Alexander (R-TN), and the Committee’s Ranking Member, Patty Murray (D-WA). The Murray-Alexander
market stabilization proposal mainly focuses on funding extensions and program maintenance while forgoing any controversial proposals or significant changes. The advancement of market stabilization activities has occurred incrementally and the path forward at the end of the year remains unclear. Expectations are that some type of compromise may be negotiated between the Finance, Ways & Means, and HELP proposals.
Complicating matters for Members of Congress still active on healthcare have been emerging efforts by the administration to undermine foundational parts of the Affordable Care Act
through the administrative rulemaking process and the sheer volume of additional items that Congress will need to address in a timely manner. In this regard, recent calls by legislators to include repeal and replace provisions in the emerging tax cut package were largely rebuffed by key Republicans.