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Senate Republicans have finally landed on a plan to tackle expiring Obamacare subsidies to counter Senate Democrats, but both are likely to fail in a vote set for later this week.
Senate Majority Leader John Thune, R-S.D., announced Tuesday that Republicans had coalesced around a proposal from Sens. Bill Cassidy, R-La., who chairs the Senate health panel, and Mike Crapo, R-Idaho, who chairs the Senate Finance Committee, to counter Democrats’ legislation.
The Senate is set to vote on the dueling proposals on Thursday.
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Cassidy and Crapo’s plan was given the thumbs up by the majority of Republicans during the conference’s closed-door meeting Tuesday afternoon, Thune said.
Their proposal, which was unveiled Monday night but has been in the works for weeks, would abandon the enhanced premium subsidies in favor of health savings accounts (HSAs), funneling the money that has gone directly to insurers through the program to consumers instead.
Thune argued that Senate Democrats’ plan, which was unveiled by Senate Minority Leader Chuck Schumer, D-N.Y., last week and would extend the subsidies for three years, would do little to curb the cost of healthcare in the country, and instead benefit affluent Americans and insurance companies.
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“This program desperately needs to be reformed,” Thune said. “The Democrats have decided we’re not going to do anything to reform it. And so we’ll see where the votes are on Thursday. But we will have an alternative that we will put up that reflects the views of the Republicans here in the United States Senate about how to make health insurance more affordable in this country, how to ensure that it’s not the insurance companies that are getting enriched, that it’s actually benefiting the patient.”
Republicans’ decision comes as more and more proposals were pitched among their ranks, reaching nearly half a dozen plans on the table for lawmakers to choose from.
Cassidy and Crapo’s plan would seed HSAs with $1,000 for people ages 18 to 49 and $1,500 for those 50 to 65 for people earning up to 700% of the poverty level. In order to get the pre-funded HSA, people would have to buy a bronze or catastrophic plan on an Obamacare exchange.
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The bill also includes provisions reducing federal Medicaid funding to states that cover illegal immigrants, requirements that states verify citizenship or eligible immigration status before someone can get Medicaid, a ban on federal Medicaid funding for gender transition services and nixing those services from “essential health benefits” for ACA exchange plans, and inclusion of Hyde Amendment provisions to prevent taxpayer dollars from funding abortions through the new HSAs.
Both plans are likely to fail, however, given that Senate Democrats have rejected doing away with the subsidies in favor of HSAs, and Republicans contend that reforms to the credits — like income caps and more stringent enforcement on taxpayer dollars funding abortions — are must-haves for their support.
Schumer argued that the “only realist path” to preventing premiums from hiking ahead of the end of the year deadline to extend the subsidies would be for Republicans to cross the aisle and vote for their plan. He charged that the GOP’s plan was a “phony proposal” that did nothing to extend the sunsetting subsidies.
“That’s what’s driving the price up, and they’re doing nothing about it,” Schumer said. “The bill not only fails to extend the tax credits, it increases costs, adds tons of new abortion restrictions for women, expands junk fees, and permanently funds the cost-sharing reductions. Their bill is junk insurance. It’s been repudiated in the past.”
Both sides face a math problem in mustering bipartisan support for their respective proposals. And it’s unlikely that lawmakers break ranks from their party’s position, meaning both bills are doomed to fail. For some, the debate has devolved into a finger-pointing contest on which side was actually serious about addressing the growing healthcare affordability issue.
“It’s not a realistic plan that the Democrats have,” Sen. Markwayne Mullin, R-Okla., said. “If the Democrats were actually coming to the table, I’d say, yes, we need to, but what they’re doing isn’t realistic.”
Before Thune’s announcement, Sen. Chris Murphy, D-Conn., said that Republicans were in charge, not Democrats.
“They’re in charge of putting together the votes to pass something,” Murphy said. “And so far, they have done zero outreach on this issue of any significance to Democrats, as far as I can tell.”
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