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Lamar Alexander and Mike Rounds: Health Care Needs a Bipartisan Fix


No one wants to ‘bail out’ insurers, and our bill wouldn’t do that.

President Trump has asked for a bipartisan short-term solution to reduce health-insurance premiums and avoid chaos in the individual market so 18 million Americans won’t be hurt.

Last week, 12 Republican and 12 Democratic U.S. senators proposed a solution. After eight years of ObamaCare speeches and votes but zero legislative victories, our bill actually could make conservative ideas law. It would permanently roll back some restrictions on states and allow anyone to buy a lower-cost catastrophic plan. To achieve these conservative victories, we agreed to extend cost-sharing reduction payments for two more years.

Sens. Lindsey Graham and Bill Cassidy are co-sponsors. This bill is not a substitute for their repeal-and-replace legislation, which wouldn’t take effect until 2020. Meanwhile, they want to avoid chaos.

Iowa Sens. Chuck Grassley and Joni Ernst are co-sponsors. The bill would allow Iowa an ObamaCare waiver to stabilize its collapsing insurance market. Waivers from Oklahoma, Minnesota and New Hampshire could also be approved. The bill streamlines the waiver process making it easier to copy ideas like Alaska’s insurance fund for the very sick, which reduces premiums 20% for everyone else with no new federal dollars.

Co-sponsors Bob Corker, Johnny Isakson and Richard Burr like the bill’s fiscal soundness. The Congressional Budget Office finds our bill will reduce the deficit by $3.8 billion. Failure to extend cost-sharing actually would add $194 billion to the debt over 10 years to pay for higher premium subsidies, CBO says. A federal court has said cost-sharing payments are illegal unless Congress acts.

Co-sponsors John McCain, Lisa Murkowski and Susan Collins want a thorough process. The Senate’s health committee held four hearings and four meetings for senators not on the committee. Sixty senators participated.

The president doesn’t want to “bail out” insurance companies. We agree, as does Sen. Patty Murray, the lead Democratic negotiator. This week CBO affirmed that our cost-sharing proposal benefits taxpayers and low-income policyholders, not insurers.

The president doesn’t want Americans to be hurt more before ObamaCare is replaced. CBO says without cost-sharing they will be: Premiums would rise and insurers would flee collapsing markets, leaving up to 16 million Americans without options. Such chaos would be a four-lane highway to single-payer insurance, a gift to Sen. Bernie Sanders. That’s why House Republicans’ repeal-and-replace bill continued cost-sharing for two years.

This week Iowa withdrew its waiver and Massachusetts was denied. States need flexibility now. Should we have negotiated more flexibility? Getting 60 Senate votes requires compromise, and the reforms we negotiated are the first in seven years. Most are changes that Senate rules won’t allow in a 51-vote repeal-and-replace budget bill.

This sounds like a proposal on its way to becoming a law. The sooner, the better.

Mr. Alexander, a Tennessee Republican, is chairman of the Senate health committee. Mr. Rounds, a South Dakota Republican, is a U.S. senator. Both are former governors.