The Washington Examiner reports that House Republicans still think that they have leverage on Cost Sharing Reduction (CSR) subsidies.
However, Congress did not include the two bills in a Dec. 22 short-term spending deal as the House GOP is largely opposed to the bills, with some calling the Obamacare cost-sharing payments a “bailout.”
That position has not changed, several conservative lawmakers said Monday.
“The CSRs are still something that most of the guys I am talking with are saying I can’t get there,” said Rep. Mark Walker, R-N.C., chairman of the 170-member Republican Study Committee….
“So far the only thing I have seen is additional flexibility at the state level. For me it is not enough,” said Cole. “I want something substantial to justify a vote for that.”
There are two ACA related bills floating in the Senate right now. The first, Collins-Nelson is a two year reinsurance bill. It would allocated $10 billion dollars to eat high cost claims. The second and older bill is Alexander-Murray. It tried to do four things. First it fully appropriated CSR for two years. Secondly, it loosened Section 1332 waiver guidelines in ways that make approvals easier and faster to grant. Next, it allocated outreach money to the states instead of Healthcare.gov and finally it allowed anyone to buy a non-subsidized Catastrophic plan while linking those plans to the common risk pool and shared risk adjustment.
There was some urgency last August and September to pass Alexander-Murray as people feared mass withdrawal from the ACA markets if CSR funding was yanked. That did not happen. Instead, insurers rolled the CSR costs into Silver premiums in most states. This led to much better deals for subsidized buyers and an increase in the number of people buying Gold plans. Funding CSR now makes many subsidized buyers worse off.
Liberals who want broader and better subsidized coverage with low out of pocket expenses will not go to the mats for CSR.
Everything else in the two packages are nice to have from a liberal policy perspective but not have to haves.
No liberal will fight for CSR at the cost of other policy goals. There is no House Republican leverage here. There may be a deal for reinsurance, 1332 guidelines and technical corrections that could get veto proof majorities in both chambers as it would leave everyone slightly happier, but that deal does not need CSR in it.