- The Washington Times - Wednesday, July 12, 2017

Ten House Democrats released a plan Wednesday that acknowledges Obamacare’s problems but proposes a series of ideas to fix them in place of the Republican push to repeal and replace the law outright.

The blueprint casts the 2010 law as a net positive that’s driven down the uninsured rate and been undermined by President Trump’s wavering commitment to enforcing it. Yet it also amounts to a rare admission by Democrats that the 2010 law is faltering in places and needs surgery.

“The Affordable Care Act has helped 20 million people access quality health care, many for the first time in their lives,” said Rep. Kurt Schrader, Oregon Democrat. “Medicaid expansion has been an unqualified success in red and blue states. But we have to face facts: Some folks in the individual marketplace have seen their premiums and deductibles increase significantly due to an imbalance in the marketplace and uncertainty caused by this new administration. Let’s fix that.”

The proposal wasn’t released by House Democratic leadership but by moderates who make up the conference’s Affordable and Accessible HealthCare Task Force.

They want to lock in reimbursements for insurers who lose money on poorer customers’ cost, and make permanent a “reinsurance” program that assists insurers who take on high-cost customers, so healthy ones aren’t force to pay more. Those ideas have been endorsed by Senate Democratic leaders, too.

They also want to strictly enforce Obamacare’s individual mandate requiring people to hold insurance, so healthy people enter the risk pool, yet said it’s worth exploring an idea that some Republicans like — auto-enrolling people into a plan with basic services.

The House plan also addresses the nuts and bolts of enrollment, from expanding outreach to herd people into coverage to aligning the signup period with tax-filing season, so people who face a penalty under the mandate can decide whether to get covered and people who expect a tax refund could reinvest that money into coverage.

And it says Congress should provide more options for older people, such as letting them buy into Medicare before they turn 65, and consider targeted assistance for people by age, geography or income for people who haven’t benefits from Obamacare’s subsidies.

Taken as a whole, the effort is designed to blunt momentum for the Republican repeal and replace effort. The House GOP has already passed a repeal plan, and Senate Republican leaders want to begin voting on their rewrite of it next week.

“To be clear, repealing and undermining the ACA are not solutions, and rolling back Medicaid expansion only further destabilizes the individual market,” House Democrats said. “Nevertheless, we believe certain reforms and recommitment to policies that work can improve the individual market and make health care more affordable.”

Republican leaders are sticking to their plan for now, brushing off the Democratic push as an insurer “bailout.

They’re looking to preserve some of Obamacare’s taxes on high earners and spread the money around to reel in GOP moderates, while hoping an idea by Sen. Ted Cruz of Texas — to split the insurance market into plans that comply with Obamacare and cheaper ones that don’t — will get a good evaluation from budget analysts and reel in conservatives.

Moderates who say the Cruz plan would increase costs for those who need robust coverage got cover Wednesday from the top insurers’ lobby, America’s Health Insurance Plans, which said segmenting the market is a bad idea.

“This proposal would cause lower enrollment in exchange markets of the younger and healthier individuals necessary for a stable insurance market,” AHIP said. “As a result, the exchange markets would basically function like a high-risk pool — with unaffordable premiums for those with pre-existing conditions.”

Mr. Cruz argues it is better to backstop those costs with direct taxpayer subsidies and stabilization funds than forcing healthy consumer to pay more.

Republicans cannot afford to lose more than two Republican votes and still pass a plan with Democrats, yet they appear to have already lost Sen. Rand Paul, Kentucky Republican who accused his colleagues Wednesday of working to keep Obamacare instead of scrapping it.

Mr. Paul is particularly angered by a parts of the bill that would enshrine taxpayer assistance for people who buy insurance on their own and offer “stabilization” funds for insurers who could see losses during the transition to a GOP model.

“Shame on many in the GOP for promising repeal and instead affirming, keeping, and, in some cases, expanding Obamacare. What a shame,” Mr. Paul said in a scathing op-ed for Breitbart News.

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