I’ve been banging the drum that Cassidy-Collins is a plausible framework of a deal since January. It still is in play.
Let’s start with a statement from Senator Cassidy (R-LA) from last week:
“There’s a widespread recognition that the federal government, Congress, has created the right for every American to have health care,” he said, warning that to throw people off their insurance or make coverage unaffordable would only shift costs back to taxpayers by burdening emergency rooms. “If you want to be fiscally responsible, then coverage is better than no coverage.”
And then he was on CNN pitching Cassidy-Collins last night:
— Deborah Berry (@dberrygannett) March 27, 2017
Cassidy-Collins as currently written needs a lot of work. People much smarter and more informed than me have told me that there are significant ERISA issues in Cassidy-Collins as currently written. But as a start of a discussion that could conceivably aim for 65 or more Senators getting on board, this is a vehicle which could entrench the expectation that everyone gets some decent if not great coverage.
Democrats should be happy about opt-out enrollment, alternative coverage pathways for Medicaid expansion eligible individuals and solving the “Mississippi Problem.” They should also be happy that this bill cements a blocking coalition for future major cutbacks to medical care eligibility and services.
Democrats will be disappointed in the gross under-funding of the bill. Cassidy-Collins as currently written projects to spend roughly 95% of what the ACA spends to cover significantly more people. On-Exchange subsidized actuarial value averages to be a little better than Gold and similar to Medicare. Spending a little less money on a lot more people will mean that the average actuarial value will crash and deductibles and other out of pocket expenses will increase.
But those are areas of negotiation within a shared framework and expectations. A Senate deal is plausible. And it looks like a gang of 10 could be forming in the Senate.
— Niels Lesniewski (@nielslesniewski) March 28, 2017
There are significant policy concerns that would need to be hashed out in the Senate. There is one major political concern. Any bill that comes out of the Senate would need a House Speaker willing to Boehner himself to get it to the House Floor where it would pass with at least 50% of the minimal winning coalition comprised of Democrats. I have no idea how that happens.
But we need to keep an eye on Cassidy-Collins and figure out if there is a good reason to productively engage (in my opinion yes) and then actually see if good policy can be made.