Re-elect Dan Lipinski Congressman

Congressmen Unveil Obamacare Compromise

07/31/2017

Crain's Chicago Business

With the backing of at least three Chicago-area members of Congress, a bipartisan group of 43 House members today offered a compromise plan they said would stabilize the national health care market after the collapse of Senate efforts to repeal and partially replace the Affordable Care Act.

The $215 billion proposal includes some things designed to appeal to conservatives, such as repealing Obamacare's tax on medical devices and limiting the employer mandate to companies with at least 500 employees, up from 50 now. And there are some things Democrats will like, such as a big new reinsurance program to help insurers that end up with a disproportionate share of older and sicker clients.

There was no immediate indication that congressional GOP leadership will go along , or that President Donald Trump will back off his vow to let ACA implode by cutting off federal subsidies to companies that provide insurance policies under ACA's health exchanges. Still, the effort is the first significant move toward compromise since last week's Senate votes.

The proposal formally comes from the House Problem Solvers Caucus. One of the representatives who is actively involved, Rep. Dan Lipinski, D-Chicago, says the plan should prevent Obamacare coverage for millions of Americans from "imploding" amid congressional gridlock.

"The American people are tired of the status quo in Washington. They want their representatives to work together," he said. "The purpose of this plan is not to solve all the issues with the ACA, but to take commonsense steps that will make it work better."

In a statement, the group says Channahon Republican Rep. Adam Kinzinger supports the plan—Kinzinger's office confirmed that—and quotes Lincolnshire Democrat Brad Schneider saying the proposal is "a first step. . . .Progress is indeed possible." Schneider's spokesman said he's "looking forward to gathering feedback from constituents and stakeholders over the August recess on these initial ideas."

FIVE PROVISIONS

The proposal, which would be paid for through health care spending cuts that were not detailed today, has five basic provisions:

• Bring under direct congressional control, but make mandatory, billions of dollars of payments to insurers that Trump has threatened to cut off. The subsidies lower coverage costs for households earning between 100 percent and 250 percent of the federal poverty level.

• Create a "dedicated stability fund"—reinsurance—that states can use to cut premium costs, especially for those with pre-existing conditions. This is similar to a clause that was in the "skinny repeal" plan the Senate rejected, but far short of the full Obamacare repeal that some conservatives want.

• Adjust the employer mandate not only by exempting most small companies, but by defining a "full-timer" entitled to coverage as someone who works 40 hours a week. Some Democrats may balk at that as prone to misuse by employers who will hold their workers just short of the 40-hour standard.

• Repeal the medical device tax, a roundly detested 2.3 percent sales tax that members of both parties have wanted to dump.

• Give more guidance and speed up approval of waivers for states that want to experiment by, for instance, allowing interstate sale of insurance products.

Lipinski said he's hopeful the proposal will gain some momentum, but said much depends on whether a similar group in the Senate is able to agree on this or a similar plan.

"Ultimately, it depends on what the political calculus is," as leaders in both parties determine whether they are better off agreeing on a compromise or letting the system collapse and blaming the other party, Lipinski said.


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