Caitlin Owens at Axios reports that Senator Alexander (R-TN) is still trying to put together an individual market stabilization bill.
Sens. Lamar Alexander and Susan Collins have proposed a market stabilization package that would include funding for the Affordable Care Act’s cost-sharing reduction subsidies for three years, three years of federal reinsurance at $10 billion a year, additional ACA waiver flexibility for states, and expanded eligibility for “copper” plans….
I am still stuck as to why Senate Republicans believe that Senate Democrats want to have Cost Sharing Reduction (CSR) subsidies appropriated?
Silver Loading has led to significantly lower premiums after subsidies for individuals who earn between 100%-400% Federal Poverty Level (FPL $12,140-$48,560 for a single individual in the contiguous 48 states). Colin Baillio shows what happened in New Mexico:
Funding CSR hurts subsidized buyers in parts of 48 states.
Funding reinsurance does not directly hurt subsidized buyers. That is a possible area of agreement.
Expanding Catastrophic coverage eligibility does very little if Catastrophic plans are tied into Metal level risk adjustment. That is a possible area of inconsequential agreement.
Expanding the Section 1332 guardrails using the same language from Alexander-Murray is a reasonable area of agreement.
Ordering CMS to hurry up and issue Section 1333 Interstate Insurance compact regulations is an area of plausible agreement.
Everything except CSR funding are low conflict areas of agreement.
I am still scratching my head at the set of Republican concessions that will get Democrats to agree to fund CSR? I could see an agreement where CSR is funded but premium tax credit subsidies are available to anyone so that no one spends more than 10% of their income on the Benchmark Silver plan. I could see CSR being funded if it is also bumped up so that people earning between 200% and 300% FPL have a baseline Gold Plan. I could see something where everyone gets something and gives something. But at this point, enacting Alexander-Murray and Collins-Nelson as written in the fall is primarily Democrats giving up policy and political concessions with little in return.