Can Republicans come together on a healthcare reform package before the government shuts down?
The healthcare reform bill that was once thought dead lingers on life support after all. Last week, President Donald Trump reiterated his desire to get an Obamacare repeal and replacement bill passed soon, possibly as soon as this week, even after the GOP-backed American Health Care Act (AHCA) failed to garner enough support within Republican ranks to bring it before the entire House for a vote.
Late last week, a flurry of media reports suggested that the hard-line conservative Freedom Caucus members and leaders from the moderate Tuesday Group were furiously negotiating a health insurance bill compromise. CNBC contributor Larry Kudlow said on air that Freedom Caucus Chairman Mark Meadows (R-NC) and Sen. Susan Collins (R-ME), a moderate, had reached a consensus on a number of issues and that the revised bill had nearly gained the 216 votes needed for passage in the House. “If the House can get a vote next week or soon after, the Senate may jam it right through fast. It won't take weeks and weeks and weeks,” Kudlow said.
Subsequent reports, however, questioned whether Republicans had actually written and agreed upon a revised healthcare bill. “The question is whether it can get 216 votes in the House, and the answer isn't clear at this time,” a senior GOP aide told Politico. “There is no legislative text and therefore no agreement to do a whip count on.”
The Politico article further reported that Tuesday Group co-chair Tom MacArthur (R-NJ) hadn’t obtained the backing of the full group for the changes, an opinion echoed by centrist Rep. Dan Donovan (R-NY). “The amendment doesn't address the things that I had concerns about — the things I think are detrimental to the people I represent," Donovan said.
Possible Government Shutdown
Hanging over the seemingly endless healthcare debate is the possible government shutdown if a budget agreement isn’t reached by April 28. The two issues are related in that President Trump recently proposed withholding the federal funds enabling low-income people to obtain subsidies for health insurance under the Affordable Care Act. Doing so, President Trump reasoned, would force Democrats to bargain for revised healthcare legislation.
But Bloomberg columnist Albert R. Hunt wrote that President Trump was likely “bluffing” when he made that suggestion. Health insurers now preparing rate filings for next year have also expressed concern that withholding the subsidy funds would throw the individual marketplace into a tailspin. A New York Times article reported that the National Association of Insurance Commissioners recently sent a letter to Congress stating, “Your action is critical to the viability and stability of the individual health insurance markets in a significant number of states across the country.”
Democratic leaders, like Sen. Chuck Schumer (D-NY), indicated little inclination to enter negotiations. Furthermore, it’s quite possible that cobbling together a government funding bill will take precedent over finding a healthcare solution.
What a New Healthcare Bill Would Look Like
Though by all reports a revised healthcare bill has yet to be finalized, some details have emerged about what it would look like. Most of the changes center on shifting several Obamacare mandates to the states.
According to Townhall.com, Meadows and MacArthur’s compromise bill permits states to request a waiver from the ACA’s community rating rule prohibiting insurers from charging higher premiums to people with pre-existing conditions. To cover those with chronic medical conditions, states must establish high-risk pools where those individuals could purchase coverage — a provision included in the original AHCA. But Democrats counter that removing the community rating provision would dramatically hike premiums for sicker individuals.
In addition, states could decide on the essential healthcare benefits included in every policy. Republicans contend that freeing insurers from those restrictions would result in lower premiums.
Critics, however, maintain that basic, bare-boned policies might leave people uninsured when an unforeseen health crisis hits. In an opinion piece for Forbes, Gary D. Alexander, former Secretary of Human Services in Pennsylvania and Rhode Island, argued that pared-down, less expensive health policies might not serve policyholders well. “Once diagnosed with something not covered, and unable to afford the stratospheric prices of adding in coverage afterward, that constituent may end up in the ER, out of work or on government welfare,” he wrote. “Future illness and accidents can’t be known, so it’s impossible for people to make totally informed choices.”
Clients Still Need Insurance
Despite continuing discussions about healthcare reform, an Obamacare replacement remains elusive. For agents, this situation creates ongoing confusion over how clients can insure their healthcare needs.
As a trusted advisor, keep abreast of any possible changes on the horizon and how such revisions could affect your clients. It’s better to prepare your clients now for those changes so they can easily adjust to a new law.
With so much uncertainty, your clients may be tempted to switch healthcare plans. Yet that may not be the best course of action. Stress to your clients the importance of maintaining their current health insurance policy so they have coverage for any medical urgency as Congress sorts out new legislation.