Democrats Demand Action To Solve Rising ACA Premiums

Democrats left little doubt Wednesday that heath care will be their signature issue in the mid-term contests, betting the GOP's decision to weaken Obamacare as part of its tax overhaul will give them a winning platform to run on while vulnerable senators are tethered to Capitol Hill this August.

Senate Republican leaders this week said they are canceling most of their summer vacation to stay and work on confirming President Trump's nominees and to make headway on the annual spending bills.

But Minority Charles E. Schumer said Democrats will try to turn August into a referendum on health care, demanding action to solve rising Obamacare premiums.

Democrats say the GOP's move to scrap the 2010 health law's "individual mandate" is fueling the premium increases. They say taxpayer funding and government options are the answer.

They're demanding action on five ideas: letting the federal government use its authority under Medicare to negotiate down the cost of drugs; enhancing Obamacare's tax credits and help for out-of-pocket costs; funding a federal reinsurance program; letting people buy into Medicare before they reach age 65; and creating incentives for 17 holdouts states to expand Medicaid to people making 138 percent of the federal poverty level.

"The number one thing Americans want is health care, and we Democrats will spend August recess focusing on that issue, and forcing Republicans to cast votes or deny votes on those important issues," Mr. Schumer said. "It's a great opportunity, not just for Democrats, not just for Republicans, but for America."

The push sets up a direct clash with the Trump administration and its GOP allies, who insist Obamacare is collapsing under its own weight.

The administration is finalizing rules that allow trade groups buy "association plans" across state lines, and letting people hold "short-term plans" for a full year, instead of the three-month cap imposed by President Obama in 2016.

The plans do not have to comply with Obamacare's strict coverage rules, meaning healthy people who've been priced out of Obamacare might see them as a more affordable option.

"Association heath plans will actually bring down the cost of insurance for the 28 million people left out," Health Secretary Alex Azar said in a tense exchange Wednesday with Rep. Bobby Scott, a Virginia Democrat who said the administration's moves are spooking Obamacare insurers, forcing constituents to pay more.

Even though Republicans failed to repeal Obamacare, Mr. Trump says scrapping the mandate to hold insurance still took a big bite out of the law and should be celebrated as a major GOP achievement.

Yet it comes with politics risks.

About two-third of voters told a recent CBS/YouGov poll they want their candidates this year to talk about health care — a bigger share than any other topic — and six in 10 Americans told the Kaiser Family Foundation this year that the GOP is now responsible for Obamacare, after its repeal debate last year.

Insurers say the mandate, while it may not have met Democrats' lofty enrollment goals, did goad healthy people into the marketplace. Without them, insurers expect to raise rates to cover costlier customers.

"Insurers have attributed approximately half of their requested rate increases to the risks they see resulting from its repeal," New York Financial Services Superintendent Maria T. Vullo said Friday in announcing that insurers requested an average rate increase of 24 percent for 2019.

Larry Levitt, a senior vice president at the Kaiser foundation, said insurers had finally figured out the individual insurance markets under Obamacare and the country would likely have seen only modest premium hikes before the GOP's changes.

"How premium increases play in the election is whether Democrats can get the message across to voters that Republican policies are pushing premiums up in 2019, or whether Republicans can convince the public that the ACA is failing," he said. "This will be a spin battle as the election approaches and more premium increases become public, but so far it seems like Democrats have the upper hand."

Fighting for a foothold, Mr. Azar said Wednesday the problem is Obamacare's own design, since taxpayer subsidies chase rising premiums.

"There's no incentive for insurance companies in any way to contain their cost increases," Mr. Azar told the House Education and Workforce Committee.

Senators tried this spring to craft a bipartisan stabilization plan that would have freed up billions of dollars in "cost-sharing" payments to insurers and "reinsurance" money to subsidize pricey customers, so everyone else could pay less.

That fell through when Democrats balked over pro-life language that was more stringent than what was included in the original Obamacare.

Senate Health Committee Lamar Alexander says legislative approaches are dead this year, so states and the administration should find ways to cut costs.