The Washington Examiner had a piece earlier this week on how House Republicans want another pound of flesh to pass Alexander-Murray:
A top House Republican said Democrats need to make concessions that make them “wince” in order to get a vote on two Obamacare stabilization bills….Cole, a member of the House’s whip team, said the two bills are going to be a tough sell to Republican as they’re currently written.
“If that is what you want to get through, you had better put something with it that Republicans like because in the package right now there isn’t anything commensurate with what they are being asked to give up,” he told reporters on Monday.
This is a fundamental misreading of leverage and policy preferences.
There are four major elements in Alexander-Murray. The first is a two year appropriation for Cost Sharing Reduction subsidies. Secondly, outreach activities would be sent to the states instead of HHS. Finally there would also be reasonable changes to 1332 requirements and window-dressing changes to Catastrophic plans.
What happens if CSR is appropriated when measured against current reality instead of CBO baseline?
- Significant money (CBO estimates $194 billion) is pulled out of the individual market
- Senator Collins has an easier time voting yes for the tax bill
- Late October, the following occurs:
- Headlines “ACA rates drop for 2019….”
- Subsidized buyers go from seeing really good deals to normal deals (from Avalere)
That is what would happen if Alexander-Murray passed this afternoon with no modifications.
Why would Democrats want or need to make further concessions?
Making it easier for Senator Collins to vote for the tax bill increases the probability that thirteen million more people are uninsured according to the CBO. That is not a Democratic policy preference.
Muddling the messaging that the Republican Party owns healthcare is not a Democratic political preference going into the midterms.
Making insurance more expensive for subsidized buyers is not a Democratic policy preference.
Walking away from an Alexander-Murray bill that funds CSR produces acceptable outcomes for Democrats. I do not understand the analysis that suggests that Democrats are the ones who need to offer concessions for the outcomes that Alexander-Murray delivers.