• Daniel Ethan Finneran

Will "Alexander-Murray" Triumph?

October 2017

These recent and recurrent tag-team approaches to healthcare reform have a certain appeal. With surnames stapled together and tossed to Congress, these binomial bills à deux, have become the recent trend. First came Graham-Cassidy in late September, the health-savings-account-heavy proposal that fell flat on the Senate floor. Now comes its successor, Alexander-Murray. It’s another example of two senators lending both their names and best intentions to change the status quo.

One can appreciate the risk a person takes when he or she puts his or her name on proposals whose success almost always augurs ill. There’s forever a face to attach to the folly if their namesake succeeds and doesn’t deliver, or if it fails to even get that far. Therein lies the appeal. It’s a risk, but not one without slight potential for reward.

Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) have introduced this latest proposal to reform the Affordable Care Act. To do so, they reached across party lines, which has become something akin to working treasonously behind enemy lines. Their bipartisan endeavor was many months in the making, and perhaps would’ve lasted longer but for the exigencies we now face.

The pressing need for substantive healthcare reform presses upon us more strongly than before. This was made obvious on Friday when President Trump announced that cost-sharing subsidies would no longer be funded. These subsidies, which promise subventions to the insurance companies covering indigent Americans, are vital if Obamacare is to be sustained and if the present healthcare market is to remain stable. Without them, as I mentioned in a previous post, the insurance companies would be forced to increase premiums on wealthier policy-holders to recoup the costs. Impoverished people would be assured access to their health insurance, as per the ACA’s decree, but the companies providing the coverage couldn’t conceivably do this for free. Without some new, concrete amendment, the whole situation is made fraught.

This situation leaves insurers, policy holders, and politicians looking ahead at an unnervingly uncertain future. Senators Alexander and Murray sensed this burgeoning urgency and revealed their bill. On its major points, the bill is rather straightforward. In exchange for continuing to fund the Affordable Care Act’s cost-sharing subsidies, Alexander and Murray’s bill proposes giving states more discretion and regulatory flexibility in dealing with healthcare markets. Like its Graham-Cassidy predecessor, this proposal provides a similar, albeit softened approach to prioritize before all else a state’s autonomy. Provincialism remains key, as the underlying GOP effort is to shift the focus away from the central government and back to the states.

The Alexander-Murray deal, which touts itself as “a bill to stabilize individual market premiums and provide meaningful state flexibility” would extend funding for Obama’s cost-sharing subsidies until 2019. At that point, the subsidies would be re-addressed and probably lessened. By guaranteeing to extend these subventions for at least two years, the Alexander-Murray bill seeks to stabilize markets in the short-term. In turn, this would give the government and the insurance companies time to re-organize for the future, all while obviating the potentially onerous premium spikes for beneficiaries.

The proposal would also allow individual states to apply for ACA waivers. These waivers would make it possible for the interested states to avoid the ACA marketplace altogether, so long as the state promises comparably affordable plans. Finally, state plans must be made to offer “minimum requirements”, or those benefits understood to be essential and fundamental to any proper health insurance plan.

Unlike its predecessor, the Alexander-Murray proposal is showing promise. Astonishingly, it has garnered support from both sides of the political aisle. From the Left and Right, many unlikely characters have committed their support. John McCain, the recent thorn in many Republicans’ sides on the senate floor and President Trump’s incessant bête noire, smiled upon the plan. He called it a “sign of increased bipartisanship moving forward”. This is not to say his vote is cast, but he appears willing to give it a nod.

Senator John Thune (R-SD) said that the Alexander-Murray deal is “something I think will attract a good number of votes for people who want to see a near-term solution that ensures stability in the markets and enables and sets up a debate down the road”. He continued to hold out hope that “down the road”, that ever-atemporal time, Congress would be able to implement a “more comprehensive solution” like Graham-Cassidy to finally “repeal and replace Obamacare” once and for all.

Surprisingly, Democrats were equally sanguine about the deal. Senator Tim Kaine (D-VA) said that he thinks the proposal will pass. West Virginia’s Steve Manchin is likely to support the deal, and others are expected do the same. Senate minority leader, Chuck Schumer said that Democrats “think it is a good solution” and that it got “broad support when Patty and I talked about it with the caucus”. He continued to say that “we’ve achieved stability if this agreement becomes law”. Indeed, stability would be

a welcome change.

However, not every senator—Republican or Democratic—is on-board. Some have shown hostility to a deal that remains essentially Obamacare. Others have shown trepidation in accepting the vitiating changes to Obamacare’s vital pieces. Still others have the creeping and discomfiting question of whether or not they can endure another possible failure in healthcare reform. Can they absorb yet another defeat, which would only add to their unpropitious congressional pedigree? This question is especially pressing with mid-terms elections soon set to take place.

If Congress had hoped to find guidance from the Executive Branch on the matter, it was left wanting. Speaking from both sides of his moue, President Trump commended and then criticized the Alexander-Murray proposal. Within hours he was at once for and then against the plan. He said on Monday that it was a “good, short-term solution”, before quickly changing his tune on Wednesday by tweeting that “I can never support bailing out insurance companies who have made a fortune with Obamacare”. He was gruntled, however, to watch Democrats respond to his call for them “to take responsibility for their Obamacare disaster and work with Republicans to provide much-needed relief to the American people”. With that caveat of commendation, he continued on to say that “Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies”.

This flies in the face of what Senator Alexander told Axios’ Mike Allen about Trump’s role in crafting the deal. He said that the president “completely engineered the plan that we announced yesterday” and that “he wanted a bi-partisan bill for the short term”. Trump since has made clear this isn’t his prevailing desire. And I doubt very much that he “completely engineered” anything at all. Such an attestation can be immediately dismissed. That’s not to imply he’s incapable of achieving such a feat (I’ll leave open that notion to your better judgement), but the queen bee isn’t known to make the honey—that’s left to the ergate class.

Even if a few senators dissent, this deal doesn’t look like it will sink; the bi-partisan appeal has proven itself too broad. It could be the first, palatable piecemeal bill that we’ve all been patiently awaiting.

0 views0 comments

Recent Posts

See All

Success, ‘tis said, yet more success begets– On the prosperous rains ever more profits. So reads the adage of the Gospel’s Jew: The iron law, the Effect of Matthew. “To him who has much, more will be

The tree of government is triply branched, In three portions split, in three segments tranched: Nearest the root is where Congress is housed (Of whose brainless bugs, it should be deloused!) The branc