Senator Health, Education, Labor, and Pensions Chair Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) Oct. 17 announced they reached a deal to stabilize the health insurance marketplaces. The deal, which may change in the coming weeks, would continue the cost-sharing reduction (CSR) payments for two years in exchange for additional flexibility to states via the Section 1332 state innovation waiver process. The administration Oct 12 announced that it would stop making the CSR payments, effective immediately [see Washington Highlights, Oct. 13].
While initially supportive of the bipartisan deal, President Trump now opposes the legislation as currently drafted. Several Republicans have also expressed their opposition to the legislation, including Rep. Mark Walker (R-N.C.), chair of the Republican Study Committee. However, a bipartisan group of ten governors sent a letter to House and Senate leadership urging support for the legislation.
Sens. Alexander and Murray are now working to garner support for the legislation, preferably before the 2018 premiums are irreversibly set. As of Oct. 19, twenty-two Senators have cosponsored the legislation, evenly split between Republicans and Democrats. Notably, both Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), the authors of the legislation most recently brought forward to repeal and replace the Affordable Care Act (ACA), have cosponsored the bipartisan deal.
Next steps for the legislation remain uncertain, as a date for bringing the legislation to the floor for debate or for a vote has not yet been set. It also remains to be seen whether the deal is somehow incorporated into an end of year package.
In the meantime, a group of 19 Democratic attorneys general acted to continue funding the CSRs outside of the legislative process by filing an Oct. 18 temporary restraining order. The restraining order, filed in the U.S. District Court for the Northern District of California, is aimed at compelling the administration to continue issuing the CSR payments until the suit they have filed is resolved.