DAA Indivisible: Where we are on Alexander-Murray Compromise

This is a little longer than usual, but will get you up to speed on the health care war –

After weeks of negotiations, Senator Lamar Alexander (R) of Tennessee and Senator Patty Murray of Washington (D) announced on October 17 that they had reached an agreement on several “fixes” to stabilize health insurance markets. After months of sabotage by 45, this bipartisan bill—which has the support of 12 Republican senators and all 48 Democratic senators—has enough backers to pass the Senate and begin to undo some of the damage 45 has done. However, it faces an uncertain path.. It’s time to stop the sabotage:

What Alexander-Murray Would Do

Negotiations on Alexander-Murray took on increased urgency after 45’s latest round of health care sabotage on October 12, when he announced he would stop making cost-sharing reduction payments. The bill seeks to stabilize individual health insurance markets by:

  • Guaranteeing that cost-sharing reduction payments are made. Cost-sharing reduction (CSR) payments are made by the government to health insurance companies to help low-income families afford their out of pocket expenses. Alexander-Murray guarantees that insurers will receive CSR payments for two years. Allowing Trump to kill these payments would have cost the government an extra $194 billion over the next 10 years and resulted in higher premiums and fewer insured Americans, which means guaranteeing that insurers receive the payments saves the government money and keeps more people covered.
  • Restoring funding for enrollment outreach. 45 slashed the budget for open enrollment outreach by 90% because he thinks sowing confusion will reduce enrollment, which will undermine the Affordable Care Act (ACA). (And unfortunately, most people aren’t aware that open enrollment starts on November 1.) Alexander-Murray would restore $106 million in funding, all of the money that 45 tried to unilaterally cut.

In order to get the Republicans to agree to these changes, Democrats had to make some concessions: namely, that states have more “flexibility” to make changes to their individual marketplaces, and that more people are allowed to buy “copper” plans (which are low-cost, high-deductible plans that don’t cover more than the bare minimum). The deal isn’t perfect, but it’s far better than 45’s unchecked sabotage.

Uncertain Prospects for Passage

While the bill has enough support to pass in the Senate, we don’t know if Mitch McConnell would bring it to the floor for a vote. It also faces considerable opposition in the House, and from the White House.

  • In the Senate, Mitch McConnell has not committed to bringing it to the floor for a vote—even though it has enough support to pass.
  • In the House, Paul Ryan announced that he does not support Alexander-Murray—a significant blow to the bill’s chances of passage, since he controls what comes to the House floor. Representative Mark Walker, the Chairman of the hardline Republican Study Committee, also bashed the deal. It is unclear if Alexander-Murray has enough support to pass, even if it did make it to the floor
  • In the White House, 45 is pushing for changes that would do even more damage to the health insurance marketplaces than simply maintaining the status quo, like repealing provisions of the ACA that lower costs for everyone.

If Alexander-Murray can’t pass as a standalone bill, Democrats may demand that Republicans include it in the upcoming government funding bill in December. Since Republicans won’t have the votes to pass a funding bill on their own, Democrats have leverage to push for some of their key priorities—including Alexander-Murray.

What We Need to Do

Let’s be clear: we only support this deal because we believe it is critical that 45 not be allowed to sabotage our health insurance system, which would hurt millions of people. Democrats must hold the line against any destructive changes the White House or conservative Republicans want to this deal, such as making it easier to siphon people off into skimpy, inadequate insurance plans. The only changes Democrats should accept are ones that would make Alexander-Murray stronger, such as a provision to block 45’s executive order that will expand the availability of junk plans.

We need to encourage our Senators to support the bipartisan effort and to hold the line on changes unless they protect people’s care. So, call and say something like:

I support the Alexander/Murray effort to stabilize health insurance markets. It seems like the only path to saving health care.  I know the Senator will hold the line when it comes to more destructive proposals, and she has my support.

Senator Kamala Harris

Washington D.C. (202) 224.3553
Los Angeles (213) 894.5000

Fresno:  559.497.5109

Senator Dianne Feinstein:  
Washington:  202.224.3841
L.A.: 310.914.7300
San Diego: 619.231.9712
Fresno: 559.485.7430
San Francisco: 415.393.0707

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