Senators seek stability in health insurance market, amid Trump threats to end payments

Lawmakers are working on short-term reforms, stabilizing insurance premiums.

— -- While Senate Republicans’ efforts to overhaul the health care system failed last week, lawmakers are still working on short-term reforms, most notably to keep insurance premiums from skyrocketing next year.

“If your house is on fire, you want to put out the fire, and the fire in this case is the individual health insurance market,” Alexander said in a statement Tuesday.

The president tweeted over the weekend that he might withhold the critical payments, which he called “bailouts.”

When asked, the White House did not comment on the possibility that Congress could limit the president's ability to end the CSRs.

"It's a high-anxiety issue for our insurers," she said.

State commissioners must set rates for the following year in mid-August, around the same time the CSR payments are due, in order to give insurers time to lock in contracts for the 2018 calendar year, which are due by the end of September.

“Telling those insurers who are already contractually bound to provide coverage through the rest of 2017 that CSRs won't exist makes it very, very difficult for us, as regulators, to ask them to find contracts to ante up for 2018,” McPeak said.

Sen. Alexander has said his short-term priority is for the president to approve CSR payments for the next two months and, once lawmakers return from their August recess, for Congress to pass a bill guaranteeing insurance funds for all of 2018, including CSR payments.

“It is reasonable to expect that the insurance companies would then lower their rates,” he said in his Tuesday statement.

Senators on both sides of the aisle have underscored the urgency of approving the payments simply to keep insurance rates from spiking.

Beyond CSR payments, it’s not yet clear whether next month’s hearings will touch on broader reforms that might lead to permanent premium reductions.

McPeak said she would like to see states have more flexibility to deal with high-risk populations of patients than is currently permitted under the Affordable Care Act. She said she would be open to supporting something like a bill from Sen. Ted Cruz (R-TX) that would allow insurers to offer plans that do not cover all of the essential health benefits currently required under the ACA, but she would want even those plans to offer some mandated coverage.

But McPeak indicated that all efforts to insulate insurers from monitoring Trump’s tweets to determine policy would be a step in the right direction.

“Anything beyond month-to-month funding, which is what we're dealing with today, is going to help,” she said.