Senate Republicans decided not to put Graham-Cassidy – their latest attempt to repeal key parts of the Affordable Care Act (ACA) – to a vote. The bill did not have the votes to pass.
According to The Washington Post, they also gave no indication that they were ready to resume discussion of the bipartisan Alexander-Murray legislation that would stabilize the health insurance marketplaces.
Some Republicans worry their base will hold them responsible for failing to deliver on their promise to repeal and replace “Obamacare.”
While the ACA is safe for now, customers and insurance companies will still face uncertainty unless Congress authorizes the types of fixes included in the Alexander-Murray proposal. Enrollment for 2018 health insurance plans begins in November.
Many insurance companies have announced their intention to sharply increase premium rates because of uncertainty over cost-sharing reductions (CSRs). CSR payments help insurance companies provide coverage for lower-income Americans. President Trump has repeatedly threatened not to fund CSRs.
Alexander-Murray would protect CSRs, and insurance companies have signaled that they would reduce rates if CSRs were protected. However, Congress must act by Wednesday, which is the deadline for insurance companies to sign contracts to sell on the ACA marketplaces.
Some Republicans hoped that the premium increases would turn the public against the ACA. “They’re going to find they can’t pay for it, they’re going to find that it doesn’t work. . . . Now that will make it tough on everybody. Maybe that’s what it will take to wise people up,” said Sen. Orrin G. Hatch (R-Utah).
While Sen. Alexander (R-Tenn.) said he was willing to resume negotiations with Sen. Murray (D-Wash.), Speaker Paul Ryan (R-Wis.) has already signaled that a bill protecting CSRs would not fare well in the House.
Industry experts said the lack of action was creating an unpredictable situation.
Julie Mix McPeak, incoming president of the National Association of Insurance Commissioners, said, “I feel like I don’t have a strong confidence we know what our markets look like.”
Senate Majority Leader Mitch McConnell (R-Ky.) seemed reluctant to take up health care legislation again. “Where we go from here is tax reform,” he said.
Congressional Republicans are now under a tremendous amount of pressure to pass tax reforms that are appealing to their base. Some Senate Republicans already find themselves facing primary challenges from candidates from the more conservative wing of the party.