Holy cow! In what we might generously read as Mike Rounds finally standing up to Donald Trump, South Dakota’s junior Senator is co-sponsoring the Alexander-Murray bill! This bipartisan legislation would restore the cost-sharing reductions that Trump recklessly cancelled last week, stabilize the Affordable Care Act individual-coverage marketplaces.
Rounds is one of twelve Republican Senators joining twelve Democrats as sponsors:
- Sen. Lamar Alexander, R-Tennessee
- Sen. Mike Rounds, R-South Dakota
- Sen. Lindsey Graham, R-South Carolina
- Sen. John McCain, R-Arizona
- Sen. Susan Collins, R-Maine
- Sen. Joni Ernst, R-Iowa
- Sen. Lisa Murkowski, R-Alaska
- Sen. Richard Burr, R-North Carolina
- Sen. Bob Corker, R-Tennessee
- Sen. Bill Cassidy, R-Louisiana
- Sen. Chuck Grassley, R-Iowa
- Sen. Johnny Isakson, R-Georgia
- Sen. Patty Murray, D-Washington
- Sen. Angus King, I-Maine
- Sen. Jeanne Shaheen, D-New Hampshire
- Sen. Heidi Heitkamp, D-North Dakota
- Sen. Tom Carper, D-Delaware
- Sen. Claire McCaskill, D-Missouri
- Sen. Al Franken, D-Minnesota
- Sen. Joe Donnelly, D-Indiana
- Sen. Amy Klobuchar, D-Minnesota
- Sen. Joe Manchin, D-West Virginia
- Sen. Tammy Baldwin, D-Wisconsin
- Sen. Maggie Hassan, D-New Hampshire
Mike Rounds sponsoring a bill alongside Al Franken—Dakota War College is going to have a hard time posting that press release.
Speaking of which, why not? Here’s Senator Rounds’s attempt to keep it from sounding like he’s keeping Obamacare alive:
WASHINGTON— Following months of discussions between U.S. Sens. Mike Rounds (R-S.D.), Lamar Alexander (R-Tenn.), Patty Murray (D-Wash.) and Angus King (I-Maine), Rounds made the following statement on the bipartisan Alexander/Murray legislation, which will give states additional flexibility to tailor their health insurance market to fit their individual needs. It also temporarily authorizes Cost Sharing Reduction (CSR) payments, which will protect consumers from even higher premiums and help stabilize the market in the near-term.
“Obamacare is a rapidly sinking ship,” said Rounds. “Our agreement will give us time to stabilize the market and provide meaningful flexibility and relief to states while we continue our efforts to repeal and replace Obamacare with a competitive, market-based health care system that is actually affordable. In the meantime, we protect low-income families from even higher premiums by temporarily continuing the CSR payments for two years. Meanwhile, we are making meaningful, permanent reforms to the 1332 waiver process, which will provide much-needed relief to states and allow them to tailor their health insurance markets to fit their individual needs. Empowering the states with new opportunities to innovate and strengthen their health insurance market is a significant step in the right direction.”
CSR payments are essentially a government subsidy for low-income individuals. Last week, President Trump announced the administration would stop making the monthly CSR payments, citing a May 2016 federal court ruling which found the payments were unconstitutional because Congress had not appropriated money for this purpose.
This legislation would provide permanent, significant reforms to Obamacare’s ‘1332 waivers.’ Due to House and Senate rules, the 1332 waiver changes outlined in the Alexander/Murray legislation are not eligible to be included in “budget reconciliation” legislation, which is the vehicle being used to repeal and replace Obamacare by congressional Republicans. Those efforts will continue. Alexander/Murray also modifies the affordability guardrails in a way that maintains patient protections but allows states to innovate and develop cheaper ways to cover more Americans.
It would also legally authorize the administration to temporarily continue CSR payments for two years, similar to the provisions of the Better Care Reconciliation Act, in which 49 GOP members of the U.S. Senate supported earlier this year.
Reforms to the 1332 Waiver Process Would:
- Amend the law to provide meaningful flexibility for health plan designs;
- Streamline the waiver approval process by letting governors apply for waivers without requiring state legislatures to pass an authorization law;
- Allow for automatic approval of waivers if a state’s application is substantially similar to one already approved by federal authorities;
- Cut the approval time at Health and Human Services (HHS) in half;
- Provide additional fast-tracking opportunities for waivers in emergency circumstances; and
- Allow for waivers to last longer than under current law (six years v. five years today) [Senator Marion Michael Rounds, press release, 2017.10.19].
That 1332 waiver reform could be stretched to read as another poke at Trump, since Trump has delayed 1332 waivers for Iowa and Oklahoma.
Let Senator Rounds keep spinning Alexander-Murray as a bridge to ACA repeal-and-replace. Greg Belfrage isn’t fooled, and neither should the rest of us be. The plain fact is that, after failing thrice to repeal Obamacare while his party controls Congress and the White House (and come on: would a “sinking ship” be that hard to torpedo?), Rounds is now backing a bill to do the opposite of what Trump promised to do: keep the Affordable Care Act afloat.
And keeping the Affordable Care Act alive really is the best policy. Good call, Senator Rounds!