The Obamacare fixes that were promised to Senator Susan Collins in exchange for her support of the Republican tax bill in December appear to be in serious trouble.
Earlier this week Republicans in Congress released their plan to stabilize healthcare exchanges under Obamacare (also known as the Affordable Care Act or the ACA).
In this proposed bill there was funding both for reinsurance and for cost-sharing reductions in Obamacare health insurance subsidies. These are cornerstones of the controversial healthcare law that has reduced the number of Americans without health insurance by tens of millions of people. Details of the proposed legislation had been published on Monday.
Co-sponsors of the compromise bill are Republican Senators Lamar Alexander of Tennessee and Susan Collins of Maine and Republican Representatives Greg Walden, R-Ore., and Ryan Costello, R-Pa., in the House.
These co-sponsors are trying to get the ACA fixes into the omnibus spending bill, which must be finalized by the end of this week to avoid a government shutdown.
According to Politico, the spending bill is running into problems and its passage is not guaranteed unless both sides agree to compromise on some major sticking points.
And, in a serious setback, The Hill has reported that the final version of the House spending bill did not include the ACA language. Although the Senate is considering a way to add the language into their version of the bill and thereby force the House to accept the ACA fixes, this appears unlikely.
“They’re not in there at this point, and that is unfortunate,” Rep. Walden was reported as saying. “We’re going to see what we can do moving forward, perhaps in the Senate.”
Some of the key elements of the bill that have been published include:
- Three years of funding for reinsurance, totaling $10 billion per year.
- Three years of funding for Cost Sharing Reductions.
- Authorization for new copper plans, which would allow more people to purchase catastrophic coverage.
- A requirement that Department of Health and Human Services Secretary Alex Azar issue a rule to allow payers to sell insurance across state lines.
- Transparency for people who may want to purchase short-term insurance plans, and room for states to add additional regulations.
- Hyde Amendment provisions that would prevent federal subsidies from funding abortions.
But even if they can include the ACA fixes in the final spending bill, Republicans and Democrats have not agreed on the bill’s abortion language. Lack of agreement on abortion will probably make chances of passing the bill by the Friday deadline very unlikely.
Although Senator Collins voted for the misguided Republican tax bill based on a promise that her ACA fixes would be passed into law, this does not appear to be happening. Count it as just another broken promise by Republicans who seem determined to undermine Obamacare despite the failure of all of their efforts to repeal it.