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Congressional Efforts to Stabilize ACA Markets Continue

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Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

Michael Petruzzelli

, National Council for Behavioral Health

Congressional Efforts to Stabilize ACA Markets Continue

October 26, 2017 | Health Insurance Exchanges | Comments
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Legislators have continued efforts to approve legislation that would aim to stabilize the individual insurance marketplaces for FY2018. Following months of bipartisan negotiations, Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) continue gaining support for their approach to the issue. As of last week, more than two dozen Senators had signed on as cosponsors. This week, though, a second proposal has been introduced, this time by Chairman of the Senate Finance Committee Orrin Hatch (R-UT) and Chairman of the House Ways and Means Committee Kevin Brady (R-TX).

The Alexander-Murray proposal would fully fund the cost-sharing reduction subsidies that President Trump said he would no longer pay. These subsidies lower out-of-pocket costs for low-income individuals who purchase insurance through an Affordable Care Act (ACA) marketplace exchange. Without these payments, insurers would likely be forced to significantly increase premiums or pull out of the exchanges altogether. The agreement would also would make changes to section 1332 waiver process, impacting the individual and small group markets but not affect state Medicaid programs.

On Wednesday, the Congressional Budget Office (CBO) concluded the proposal would save $3.8 billion in federal spending by 2027. The analysis also predicts that insurers who raise 2018 premiums to compensate for the expected loss of CSR payments, would be forced to pay back $3.1 billion in rebates to individuals and the government if the legislation passes.

NEW STABILIZATION BILL EMERGES

Senate Finance Chairman Orrin Hatch (R-UT) and House Ways and Means Chairman Kevin Brady (R-TX), have released a new proposal to fund Affordable Care Act (ACA) cost-sharing reduction payments in exchange for altering other ACA provisions. The Hatch-Brady proposal is in direct competition with a bipartisan ACA stabilization bill from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA).

Unlike the Alexander-Murray bill, the new Hatch-Brady proposal would eliminate the individual mandate, expand the use of health savings accounts, and exempt businesses from the employer mandate in the hopes of garnering more conservative support. Both bills face uncertainty in Congress, which has yet to pass any legislation amending the ACA.