- Senate Majority Leader Mitch McConnell said this weekend he will schedule a vote for bipartisan legislation that restores funding for cost-sharing reduction (CSR) payments to insurance companies if President Donald Trump says he would approve the bill.
- Trump has made contradictory statements about the plan, which is named after key sponsors Sens. Lamar Alexander (R-La.) and Patty Murray (D-Wash.). Trump ended the CSRs earlier this month, and his decision was blasted by several major healthcare groups.
- A judge is expected to announce Monday whether a temporary order forcing the White House to continue the payments will be issued. More than a dozen state attorneys general are asking for the order.
Payers and others in the industry have been pushing Congress to fund the CSRs, saying the Affordable Care Act (ACA) exchange markets would be severely destabilized without them, and premium rates would likely skyrocket.
The future of the Alexander-Murray legislation introduced last week, however, is still very much in doubt. In addition to mixed signals from the White House, the bill has been panned by Speaker of the House Paul Ryan (R-Wis.). It does, though, have the support of the American Hospital Association, American Medical Association and America’s Health Insurance Plans.
While its clear there is bipartisan support for continuing the payments, members of Congress are negotiating what other elements might be included in the bill. Also, the terms of the agreement could be included in other legislation. Congress has still not reauthorized the Children's Health Insurance Program, and budget negotiations are ongoing.
Meanwhile, supporters of the ACA hope to make up for the administration's decision to drastically reduce funding to promote open enrollment, which begins Nov. 1. There is concern that some enrollees will be locked into a plan they may not want because automatic re-enrollment will happen the day after open enrollment ends. Previously, people set to be automatically re-enrolled were notified and then had several weeks to make changes.
The decision to end the CSR payments, along with the changes limiting open enrollment and severely cutting back efforts to promote it and an executive order rolling back plan benefit requirements, show that the administration is taking agressive action on its promise to undercut the ACA. The health industry will be watching Congress and other outside efforts to staunch the bleeding.