2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Alexander-Murray

I know I rip on Republicans a lot here at ACASignups.net, and I stand by pretty much all of it. Once in a while, however, a GOP member of Congress does do (or tries to do) something useful when it comes to healthcare policy...and the name most often attached to that is Senator Lamar Alexander of Tennessee. Alexander happens to be retiring, I should note. These two facts may or may not be connected, but I digress.

In any event, Sen. Alexander and Democratic Senator Patty Murray of Washington State have been working together for quite some time now on several healthcare bills to help stabilize the ACA, reduce drug prices and so forth, to varying degrees of success. I may not have agreed with most of Alexander's ideas, but he seems to be genuinely interested in improving the situation...and of course I can't say enough good things about Sen. 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)

I visited DC last month for the Families USA healthcare conference. While I was there, I managed to arrange to meet with staffers for four U.S. Senators and two House members (in fact, the House members themselves stopped by to talk for awhile as well. None of the Senators did, but they were a bit busy dealing with Donald Trump's idiotic temper tantrum government shutdown at the time).

In my meetings, we discussed a variety of healthcare policy-related issues, but the two most important ones I focused on were:

Last fall, Dem Senator Patty Murray and GOP Senator Lamar Alexander (among the few Republican Senators actually interested in improving the ACA) got together and hammered out a deal called Alexander-Murray. At the time, the bill would have done the following:

  • Two years of subsidy funding, along with funding for the rest of 2017. There will also likely be additional steps to help enrollees with their premiums in 2018.
  • A "copper plan" for people older than 30, which would be less comprehensive than other ACA plans but would have a lower premium.
  • $106 million in enrollment outreach funding in 2018 and 2019.
  • Shorter review time for states seeking waivers from some of the ACA's coverage requirements. It's unclear what other waiver changes have been agreed to at this time.
  • Authorization for funding to help states launch reinsurance programs, which would defray the costs of covering the sickest consumers.

Of these five items, it's really the first two which would have the biggest impact: CSR reimbursement payments and a low-end "Copper Plan".

Hey, remember this?

So @SenatorCollins sold out for bills which won’t help much and aren’t gonna happen anyway.@jeffflake sold out for a promise to attend a meeting which won’t happen.@lisamurkowski sold out for destroying her own environment.@SenJohnMcCain sold out for...nothing at all. Huh.

— Charles GetCoveredBa (@charles_gaba) December 3, 2017

All eyes are on the Godawful Tax Scam Bill this week, which once again lies mostly in the hands of a handful of Republican Senators including the usual suspects like John McCain, Lisa Murkwoski and Susan Collins.

McCain's biggest beef this year has been about "following regular order"; it's the reason he shot down the GOP's #BCRAP bill last summer. Of coruse, current tax bill most certainly isn't following regular order either. Will he stick to his guns on the issue or cave under pressure this time? Who knows?

Murkowski was a healthcare hero last summer as well...but she may have been bought off by the addition of a "Polar Payoff" in the form of the bill allowing oil drilling in the Arctic National Wildlife Refuge (ANWR). This is the only reason I can think of that would explain her rather disingenously defensive op-ed piece in the Anchorage Daily News last week.