Andy Slavitt at the start of the weekend outlined some of the areas of potential agreement between Senators Alexander and Murray on a healthcare stabilization deal.
It would:
-create certainty of CSR payments for 2019 reducing premiums
-expedite waivers w guardrails
-add hi deduct optionBut mostly..6/
— Andy Slavitt (@ASlavitt) September 29, 2017
He makes a very good set of points as he discusses the deal:
Republican moderate Senators would have something to vote for. Joint fingerprints are a good thing. 8/
— Andy Slavitt (@ASlavitt) September 29, 2017
Matt Fiedler of Brookings and formerly Chief Economist for President Obama’s Council of Economic Advisers offered a strong critique of my public shrugging of shoulders on CSR payment. I think his point 8 is his strongest point and it ties to the point that Andy Slavitt is making above:
Specifically, would show Congress will not let Admin. sabotage proceed completely unchecked, partially mitigating broader uncertainty /8
— Matt Fiedler (@MattAFiedler) September 28, 2017
I am paraphrasing, but both Matt and Andy are arguing that a bi-partisan deal means at least some federal Republicans will now have buy-in to the success and failures of the ACA. We saw how Medicaid expansion gave some Republican governors strong buy-in to protecting the Medicaid expansion as Governors Baker, Kasich and Sandoval all fought for their states and against the interests of the national party throughout the summer.
And I completely agree. I think a deal that modifies 1332 waivers, and opens up Copper or catastrophic plans to more people and changes the employee mandate thresholds so that it applies to fewer firms would be a great deal on the political grounds and a good deal on policy grounds. I just don’t think that CSR needs to be part of the deal.
hellslittlestangel
Let’s hope Dems don’t choose what’s in the box and get zonked.
Corner Stone
It’s always going to be in bad faith. There is no deal to be made on health policy that will not be cheated, eroded or ignored once the “win” is propagandized.
Hunter Gathers
Donnie will find a way to fuck this up. It’s what he does.
No One You Know
I’m thinking that this opens up the probability that the people who want simple, purely ideological solutions will start to look a lot less qualified to the newly attentive voters in their own party.
But that could just be optimism…driven by the run-out clock. Which I am still very grateful for.
ArchTeryx
I rather wish Murray would just tell them all to pound sand. Just once. She’s just all too ready to bargain away the store just to find a bipartisan win somewhere. Anyone that’s been reading my comments for a while knows how I used to feel about her – strong enough to vote for a Republican in her place. Her “deal” with Paul Ryan took away my unemployment, killed my health insurance and forced me to move out of my home state or die.
I’ve since softened that stance but I’d still vote for her primary challenger every time.
I see the reasoning for a bipartisan deal but I wouldn’t trust these fuckers farther than I could throw the Capitol building. They already hosed her once.
Cermet
And will the giant orange turd sign any such agreement? Unlikely so can’t see this passing.
Roger Moore
@Hunter Gathers:
Maybe so, but that’s not a good reason not to try. At the very least, we need to keep him busy trying to fight new accomplishments rather than reversing old ones. It would also help to break off part of the GOP and get them on the right side of this issue.
Amir Khalid
@Cermet:
If the Freedom Caca threaten to hold their breath until their face turns blue, it could die in the House and not get to the Dotard.
Baud
@Cermet: He likes wins. This would be a win. He would say it repealed Obamacare.
Shalimar
I agree tangentially with Corner Stone. Trump is intentionally sabotaging the ACA and can veto any compromise bill that might mitigate that sabotage. Nothing is going to happen, as much as it would be a good thing to get dozens of Republicans supporting the tweaks that should have been happening all along.
Shalimar
@Baud: Sure, Trump would call it an Obamacare win if his coin came up heads. If it came up tails, he would support primary challenges against the Republican supporters because they favor Obamacare.
I just realized Donald Trump is Two-Face.
Baud
@Shalimar: Are you suggesting Trump cares about policy outcomes?
Shalimar
@Baud: Of course not. I am saying the direction his ego wound-directed responses take are unpredictable.
ArchTeryx
@Shalimar: Anything but. Two-Face had a rudimentary sense of honor – he always, always, followed his coin, no matter what his feelings of the moment were. Trump doesn’t do anything BUT follow his feelings of the moment.
Raven Onthill
@ArchTeryx: Also my sense of Senator Murray. The Democrats have been making concessions to the Republicans since Reagan and now they have nothing left to concede. I wish they would stop.
As to this plan, I responded to Andy Slavitt’s remarks on Twitter (I doubt he reads me, but what the hell): “Hell of a deal, though. The ACA is already tight-fisted, and this makes it moreso. Other problem: what makes you think this will silence the anti-ACA crowd? Is there any reason to believe the whole of the Republican Congressional delegation will honor the deal? Like enough it will not stop Trump.” David, why do you believe these concessions are going to help? There are no Republican moderates in Congress, there are just slightly-less-fascist Republicans. They have little power compared to those for whom Trump is not radical enough.
You’re closer to the people in this clusterf– than I am, so maybe you’re right and I’m wrong. But it looks to me like the Democrats are getting ready for another run at Lucy’s football.
Julie
So I thought of a reason why CSR certainty could be important. David, didn’t you say once that under their contracts with CMS, insurance companies can move to terminate coverage as soon as CSRs aren’t paid? Wouldn’t that still be true next year? So even if companies are charging higher premiums to cover the CSR uncertainty, what if a particular insurance company was losing money (as happened with Molina Healthcare this year). If CSR payments were all of a sudden discontinued, couldn’t the company use that as an excuse to exit the business in the middle of the year? That seems like a potentially big problem for consumers.
rikyrah
Thanks for the explanation Mayhew
artem1s
Make the GOP do it themselves. Dems have a very narrow window to put the Gross Old Party in the spotlight and demonstrate exactly how horrible they actually are at ….well, everything.
Personally I think Harris or Warren or Pelosi or someone should make repealing Hyde the price the ‘moderate’ GOP has to pay to partake in bipartisanship again. They have been demanding a mile in exchange for an inch for too long. Make them eat every bitter drop of their disgusting anti-government, Cult45 Kool-Aid.
Raven Onthill
And I see that you answered my request for analysis, which I had forgotten I tweeted. Thank you!