The Bipartisan Bill to Fix Obamacare...
Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), announced a bipartisan plan on Tuesday to restore the Obamacare cost sharing reduction payments to health insurers through 2019. The compromise plan would also include two Republican wish-list items; To allow for more state flexibility to design their own state health system and rules (with a speedier process for the 1332 waiver program), and opening the availability of catastrophic health coverage, essentially creating a new lower-cost metal tier of "copper plans".
Compromise and bipartisan collaboration sounds like a good idea. A bipartisan bill would require 60 votes which means getting the support of 12 Republicans, assuming all 48 Democrats are aligned in support of the proposed bill. But it might be done already...
“The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare,” - Paul Ryan's Press Secretary, Doug Andres
"The Alexander-Murray Bill" is the first and most viable bipartisan legislation to fix, not repeal the ACA with a chance to pass in 2017. Unfortunately, it could already be on life-support as House Speaker Paul Ryan has already expressed limited interest. House Republican leaders seem to prefer to overtly undermine the ACA and stay with a repeal strategy instead of stabilization. Trump has both supported a short-term fix, and also said he wants repeal or nothing.
From POLITICO: Senator Alexander said Trump told him by phone Oct. 14 he’d like to see a bill that funds the Obamacare cost-sharing subsidies that he abruptly cut off last week. In return, he wants to see “meaningful flexibility for the states in providing more choices,”
In the same day, Trump praised the bipartisan bill and even called it a “very good solution”, but later that same day criticized it with this tweet:
It's not a bail out. Health plans are required to make those payments and because the administration did not confirm CSR payments would continue by the September 5th rate filing deadline, carriers simply increased their insurance premiums (by about another 19% this year and 20% next year) in order to fulfill their obligation. Since middle class and higher-income earners (people earning more than 400% of poverty line) do not receive federal subsidies, they have to pay the full premium - including the additional 19% "surcharge" caused by the stopped CSR payments. That's unfair and why restoring the CSRs makes sense, even if it means compromises on other ACA rules. Another very good reason... Ending the cost-sharing reduction program actually increases federal spending on insurance subsidies by an estimated $194 billion.
Democrats would win (and some Republicans in expansion states) by restoring the CSR payments and calling a "cease fire" and ending the barrage of ACA repeal bills (at least for a while). It would resume payments for the remainder of 2017, 2018, and 2019, and also help stabilize the insurance market from 2019 forward. It seems too late to help lower 2018 rates since those plans are already filed and approved.
Republicans would win by gaining more control for their states and a speedier process for the waivers needed to modify or replace the ACA in their state with something of "comparable affordability" compared to the current ACA. The bigger deal is the expansion of catastrophic coverage availability. Under the current ACA law, these catastrophic coverage plans, with a higher out-of-pocket, are currently limited to people under age 30. The Alexander-Murray plan would make catastrophic plans available to everyone.
Here's a link to the actual draft bill acquired by AXIOS and an excellent summary and expert analysis from Timothy Jost.