A group of House Democrats, eyeing the Senate Trumpcare fiasco, are trying to advance the narrative and are pushing a bill to fix Obamacare, an effort that could dovetail into the bipartisan talks happening in the Senate as an alternative to Trumpcare. The House Democrats want to shore up markets in the counties that currently don't have coverage, and to stabilize the markets nationally.
The plan notably does not come from House Minority Leader Nancy Pelosi’s office, which has not put forward any similar proposal. An aide said Pelosi was aware of this effort and supportive of the discussion, although did not comment on the specific policies.
Still, it represents a shift from congressional Democrats’ Obamacare strategy thus far, which has largely focused on defending the law — alongside a mounting push for a single-payer-style health plan to replace it eventually.
“Some Democrats are fearful to talk about what is wrong with [Obamacare] for fear we’ll be seen as abandoning it,” says Rep. Peter Welch (D-VT), a relatively progressive Democrat who supports Medicare-for-all. But he says now is a moment to talk about fixing Obamacare, and not single-payer. “There is the practical reality that we’ve got a Republican president and a Republican Congress,” he says. “That’s not the opportune moment for Medicare-for-all. We’ve got to defend what we have.”
That said, the plan does include a Medicare expansion, a buy-in for older Americans. That was a provision that nearly made it into the Affordable Care Act back in the day, but unfortunately back in the day Joe Lieberman was still in the Senate and Harry Reid needed his vote. Lieberman single-handedly defeated it. This would help in a number of ways. First, this is the group of people buying in the individual market that face the highest premiums. Medicare buy-in would give them more affordable health care. But it would also help the insurance pool by driving down overall costs for insurers who wouldn't have to cover as many older, more expensive patients and could pass those savings to consumers.
Trumpcare is a nightmare. Millions would lose their health insurance, rates will go up for women and people with disabilities and it ends Medicaid as we know it. Call your Republican senator at (202) 224-3121 and give them a very angry piece of your mind. Then, tell us how it went.
Additionally, this proposal would create a permanent fund to offset the costs of the most expensive patients that would "funnel extra money to the health insurers who get stuck with high-cost patients." This was a temporary provision of Obamacare, set to expire next year. It would make the cost-sharing subsidies permanent, settling the uncertainty of this provision that's right now in the courts and subject to the whims of popular vote loser Donald Trump. The Democrats' plan would also direct the administration to enforce the individual mandate and to promote open enrollment periods, in an effort to increase enrollments. It would also change the open enrollment period to the spring, "to coincide with when Americans are getting their tax returns and may have some extra cash to spend on health insurance."
House Speaker Paul Ryan isn't going to be rushing this bill to the floor, but it does come at a good time when the public is clamoring for a bipartisan fix to Obamacare, not a repeal, and when McConnell is floundering with Trumpcare. It gives the Democrats who may be talking with Republicans on a fix a starting place. If that gives any Republican more room to defect and defeat Trumpcare, it's worth the effort.