Senators are talking up a bipartisan deal to continue subsidies that President Donald Trump said he would cut off.
Sen. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) maintain that their plan would stabilize health insurance markets by funding the Cost-Sharing Reduction (CSR) payments for two years. The payments are meant to go to insurers and help lower co-pays, deductibles and other out-of-pocket expenses.
However, House Republicans argue that they never appropriated the money and sued the Obama administration for improperly funding the CSRs. A federal judge ruled against the administration in 2016.
Heritage Foundation Senior Research Fellow Ed Haislmaier insists that the CSRs set up by former President Barack Obama misled the American public.
"Basically, the Cost-Sharing Reduction subsidies – paying those is really about stabilizing federal funding of subsidies,” Haislmaier asserted. “It's not about stabilizing the market. The market consists of those people who are getting subsidized coverage, but it's also people who are not subsidized, and they are the ones who are really hurting.”
In fact, the so-called CSRs actually stuck it to the very people they were supposed to help out.
“They are the ones who have been paying higher premiums, higher deductibles, [seeing] fewer choices and getting nothing – no subsidies or anything else in return,” Haislmaier pointed out. “So, to stabilize the unsubsidized market, you have to remove the things in Obamacare that are increasing their costs – the insurance mandates and regulations. So, … the question is whether the deal will have enough of that in it to be worthwhile."
He also contends that these are different subsidies than those helping people offset the cost of their health insurance premiums.
"Contrary to all the hollering, none of these people are going to lose their coverage," Haislmaier contended. "They're not even going to lose their subsidies."
Too early to tell?
More uncertainty about the toll of the health care deal reached between Alexander and Murray was expressed by Hadley Heath Manning of the Independent Women’s Forum, a take on what both parties can expect was given.
"[A] lot of the details remain yet to be seen [about the deal],” Manning shared when asked about its impact. “It's obvious what Democrats get out of this deal. They get an extension of the Cost-Sharing Reduction payments that the Obama administration was sending out without congressional appropriation.”
And here’s what conservatives in the nation’s capital are expecting from the deal.
“On the other hand, Republicans are saying that the deal will include increased flexibility for states, but we don't know what that will look like yet,” Manning pointed out. “In fact, we do know it's not going to include any flexibility on the so-called essential health benefits or the laundry list of services and features that insurance plans have to have. So, with that in mind, I understand it's a compromise. There's some give and take, but knowing so little about the details so far, it's hard to say if it's a good deal or not."
Q: These cost-sharing reduction payments or subsidies are different from the subsidies that help offset the cost of a person's premiums, correct?
She was then agreed that the CSR payments or subsidies are not the same as the subsidies that helped to offset the cost of premiums paid out by individual with coverage.
“The premium support subsidies were appropriated by Congress,” Manning informed. “They are legal. They apply to anyone who is earning 400 percent of the federal poverty level, down to 100 percent of the federal poverty level – and you can get them in any of the state-based exchanges, or [at] the federal exchange where people buy ACA plans.”
It was then noted that the money from the program gets funneled to the insurance companies – not the poor who need it.
“The Cost-Sharing Reduction payments are not made to low-income people,” Manning emphasized. “In fact, none of the subsidies are made to low-income people, but they're made to insurance companies with the idea that these payments help health insurance companies lower the out-of-pocket costs for people who earn 250 percent of the federal poverty level or below.”
And the illegality of the program was also mentioned.
“So, it's a different set of consumers who qualify for Cost-Sharing Reduction, and the cost-sharing reduction payments that were going out were going out illegally without congressional appropriation,” Manning impressed. “They were the subject of litigation in federal court. In fact, one federal court found them unconstitutional. They were operating under a stay until president trump said they would stop.”