The Hill reports that Senator Johnson (R-WI) thinks that the House Republicans are the major blocking force on funding CSR:
Other Republicans say Alexander doesn’t appear to have a grasp on the politics of the House, where anything seen as shoring up ObamaCare is likely to draw fire from conservatives.
Asked if Alexander was out of step with House Republicans, Sen. Ron Johnson (R-Wis.) said, “Just based on the communication coming out of the House since yesterday, I would say that’s an accurate assessment..”.”
The Best Alternative To a Negotiated Agreement (BATNA) is a good exercise to figure out where hard lines are. People will not agree to deals that make them worse off than doing nothing.
From the right, a CSR funding bill creates major problems during Republican primaries. The major political prize from the Republican point of view is the following two headlines next October:
” Obamacare premiums drop in SWING STATE X by 12% this year”
” Obamacare premiums due to Governor Z’s waiver are dropping another 8%”
The baseline premium drop would be the removal of Silver Loading that added 19% to Silver premiums this year. That drop is not the full 19% because of medical inflation but premiums are overpriced this year. States would be able to decrease off-exchange premiums as well by filing rapid “me-too” reinsurance waivers. Oregon just got approved for a reinsurance waiver that will lead to a 7.5% drop in premiums.
If there is no Murray-Alexander agreement to fund CSR, what is the alternative from the Democratic perspective?
- A major club to beat up on Republican incumbents in swing districts
- Silver Loading in all states
- Expectation that good insurance on the Exchanges is now a Gold plan instead of a Silver plan
- States with massive flexibility to innovate
The major political gains from the Democratic point of view on Alexander-Murray is wedging House Republicans between primary and general election electorates and getting at least some Senate Republicans as stakeholders. The policy gains are more needed technical tweaks to waivers which should lead to more state-level buy-in and outreach funding for 2019. The policy cost is funding CSR. This precludes an opportunity to reset the actuarial value benchmark from 70% AV to a benchmark in the mid-80%s AV.
No agreement involving CSR is an acceptable outcome for Democrats. They could agree to outreach funding, catastrophic plans, waiver modifications and employer mandate changes and still be better off with that agreement than no agreement. Re-funding CSR is not a critical component of Democratic policy or political objectives over the long run.
The Democratic BATNA of doing nothing to CSR is an acceptable alternative. And since one party has an acceptable outcome of no deal, they have the leverage to restrict the changes in the deal.