Lamar Alexander: The Alexander-Murray bill: Lower premiums, less debt, and new permanent flexibility for states

Congress can pass a Christmas present that would mean lower health insurance premiums for 9 million Americans who get no government subsidies.

Specifically, this Christmas present would lower premiums by 18 percent in 2019, according to a new study published today by Avalere, a health consulting company.

And according to the Congressional Budget Office, this present would also mean fewer federal dollars for Obamacare subsidies, less federal debt —and no taxpayer money bailing out insurance companies.

It has the support of President Trump and Senate Majority Leader Mitch McConnell. Senate Minority Leader Chuck Schumer has said every Senate Democrat would vote for it. And almost all House Republicans have already voted for its provisions earlier this year.

This present is wrapped up in a pair of bipartisan bills called Alexander-Murray and Collins-Nelson. It includes:

Lower premiums: Two years of temporary cost-sharing reduction payments to help low-income Americans pay for co-pays and deductibles. These cost-sharing reduction payments, when properly approved by Congress, are a short-term help not only for Americans who buy insurance on the individual insurance market — because they help prevent premiums increases of about 25 percent, according to CBO — but also for taxpayers.

Less debt: CBO said last month that making the payments would reduce Obamacare subsidies and therefore reduce the federal deficit. The CBO tells us that without these payments, taxpayers will spend $194 billion more over a decade to cover the higher subsidies that come with higher premiums. That’s why these temporary payments were a part of the House of Representatives repeal-and-replace bill and would have been part of the Senate Republican bill if budget rules had permitted it.

New catastrophic health plans: This Christmas package also includes a new catastrophic insurance policy with lower premiums and higher deductibles to draw young people into the insurance markets.

New flexibility for states: This bill includes new waiver authority for states to come up with their own ideas to reduce premiums. Alaska has already reduced premiums by 20 percent using such a waiver. Minnesota, Iowa, Oklahoma, and others have already submitted their ideas.

Invisible risk pools: $10 billion for invisible risk pools or reinsurance funds to help states do more rapidly what Alaska, Minnesota, and Maine have done to lower premiums. This was a compromise idea included in the House Republicans’ repeal and replace bill.

When President Trump followed a court’s ruling earlier this year and ended the previous administration’s unconstitutional payments of the Affordable Care Act’s cost-sharing reduction payments — because they had never been approved by Congress — he gave Congress a job: Take care of our people, prevent chaos, approve the payments, and don’t bail out insurance companies.

So, that’s what we did. With input from four hearings in the Senate health committee and meetings attended by more than half of the Senate, Sen. Patty Murray, D-Wash., and I wrote a bill that would fund cost-sharing reduction payments for two years, give states a fast-track to freedom from Obamacare, and allow anyone at all to buy a lower-cost catastrophic “copper” healthcare plan.

The Alexander-Murray bill has 12 Democrat sponsors and 12 Republican sponsors. President Trump said this week he supports the package. Sen. Schumer told "Meet the Press" on Oct. 22, “We have all 48 Democrats, 12 Republicans, I would urge Senator McConnell to put it on the floor immediately, this week. It will pass, and it will pass by a large number of votes. That'll put pressure on the House, because let's not forget what this bill does is prevent premiums from going up 20 percent, even more in some states.”

The proposal by Sen. Susan Collins, R-Maine, and Sen. Bill Nelson, D-Fla., is based upon the experience of Maine and Alaska in using invisible risk pools and reinsurance funds to create a pool of money to pay for the healthcare needs of the very sick, thereby reducing premiums by as much as 20 percent for everybody else. This idea was supported by almost every witness who came before the Senate's health committee during our hearings on stabilizing the individual market.

The Christmas season is a good time to give a Christmas present both to taxpayers and to hardworking Americans who have been struggling to pay for skyrocketing insurance premiums. Alexander-Murray and Collins-Nelson should become law before the end of the year.

Sen. Lamar Alexander, R-Tenn., is chairman of the Senate’s health committee.