2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

BREAKING: Alexander-Murray is dead. Long live Alexander-Murray!

For a good six months or so from the fall 2017 to spring 2018, retiring Republican Senator Lamar Alexander and Democratic Senator Patty Murray tried to hash out a deal which would have, had it actually been passed and signed into law, resolved some (not all) of the ACA's stabilization issues...although at a pretty ugly cost:

  • Reinsurance: GOOD!
  • Guaranteed Ad/Outreach Funding: Good! (but only necessary due to Trump cutting funding in first place)
  • Short-Term Plan Notifications: Good! (but only necessary because of #ShortAssPlan EO in first place)
  • BHP Funding: Mostly Good w/a possible Meh.
  • Waiver Flexibility: Mostly Good.
  • Copper Plans: Meh.
  • CSR Funding (with Silver Loading allowed): (NET NEGATIVE)
  • CSR Funding (with Silver Loading prohibited): (it's complicated)
  • Short-Term Plan FEDERAL OVERRIDE: DEAL-BREAKER
  • Abortion Prohibition: DEAL-BREAKER
  • ShortAssPlan Expansion: DEAL-BREAKER (via separate bill)

Overall it was a mixed bag, and the #SilverLoading workaround made both the finances and politics of the package even messier. In the end the whole thing was scrapped, in large part due to the abortion language poison pill. As I've noted several times since then, thanks to Silver Loading (and especially Silver Switching), appropriating CSR funding has gone from being something which the Democrats desperately wanted to have done to being something which...well, it'd actually end up harming more people than it helps, so it'd literally be a a net negative now.

Alexander-Murray was effectively dead after the abortion language debacle.

Today, however, a new Alexander-Murray healthcare reform package was released...except it looks a little different:

A new bipartisan Alexander-Murray proposal addresses health care costs:

Curtailing surprise medical bills.
Creating a national health care claims database.
Requiring insurers to be more transparent about provider networks and expected patient costs.

https://t.co/fD8FXhDEtL

— Larry Levitt (@larry_levitt) May 23, 2019

The Alexander-Murray proposal reflects a growing consensus that patients should be shielded from surprise medical bills. The sticking point remains how much insurers should be required to pay out-of-network providers. The proposal presents three options for discussion.

— Larry Levitt (@larry_levitt) May 23, 2019

The Alexander-Murray proposal also curbs anti-competitive practices that can drive health care prices up. pic.twitter.com/GnpeFWHsgA

— Larry Levitt (@larry_levitt) May 23, 2019

This Alexander-Murray proposal includes tangible steps to address health care costs that can attract bipartisan support, sidestepping partisan fights over ACA repeal and Medicare-for-all.

— Larry Levitt (@larry_levitt) May 23, 2019

The Alexander-Murray proposal would not solve health care affordability. But, it offers incremental steps that move in the direction of lower costs.

— Larry Levitt (@larry_levitt) May 23, 2019

Sure enough, when you look at the full explainer, there's nothing about CSRs, #ShortAssPlans, BHP funding, 1332 waivers, Copper plans...or even abortion. Instead, it pretty much amounts to:

  • Ending Surprise Medical Bills
  • Lowering Prescription Drug Prices
  • Improving Transparency in Health Care
  • Improving Public Health, and
  • Improving the Exchange of Health Information

All of these are Good Things (depending on the specifics, of course), and I'm sure they'd help to some degree...but they have nothing to do with anything in the old Alexander-Murray bill package.