Burlington County Times

Rep. Tom MacArthur Seeking Support For Health Care Stabilization Plan

Burlington County Times — August 17, 2017

By David Levinsky, staff writer

Congressman Tom MacArthur says he has reached an agreement with the chairman of the conservative House Freedom Caucus on a new health care proposal intended to stabilize marketplaces and bring down the expense of premiums without repealing the Affordable Care Act.

MacArthur, R-3rd of Toms River, had been discussing a stabilization measure with Republican Freedom Caucus chairman Rep. Mark Meadows, of North Carolina, for several weeks. On Tuesday, he said he and Meadows had reached an agreement and are now pitching their plan to key Republican senators in hopes that it will be considered quickly in both chambers early next month.

MacArthur declined to share details about his proposal because he's still negotiating with senators, but he said it would include funding for cost-sharing reduction subsidies paid to insurers to keep out-of-pocket costs manageable for low- and moderate-income insurers.

The subsidies, which are separate from the tax credits awarded to consumers to help defer some of the expense of their premiums, have become the focus of the health care debate following the Senate's failure to pass an overhaul of "Obamacare."

About 7 million consumers who purchase insurance receive the benefit, which includes reduced copays and deductibles, including about 145,000 New Jerseyans.

The payments are the subject of litigation, and President Donald Trump has called them a "bailout" for insurance companies. He has also threatened to withhold the payments, arguing that doing so could cause the collapse of Obamacare and force Democrats to help pass a new health care law.

The Congressional Budget Office reported Tuesday that withholding the payments would not likely cause the collapse of insurance market or much change in the number of insured residents. Instead, the office predicted it would cause the cost of some premiums sold on the individual markets to rise 20 percent next year.

Because the Affordable Care Act's tax credits for premiums are still intact, the projected rise in premiums would cause the federal expense to increase and add a projected $194 billion to the deficit over the next decade.

MacArthur said that he supports funding the cost-sharing payments, but that his proposal also includes provisions intended to bring down health insurance costs.

"(Cost-sharing reduction subsidies) don't do anything to bring down costs. They just move the costs from the policyholder to the taxpayer. I support it because these are poorer people, but we also have to actually get the cost of health care insurance down. And those are some of the other provisions," MacArthur said.

While the details have not been released, the website Axios.com, which first reported on the MacArthur-Meadows talks, indicated that a key part of the discussions involved increasing states' flexibility to receive waivers from some of the Affordable Care Act's insurance benefit requirements and to set up "high-risk pools" for consumers with pre-existing conditions whose coverage has lapsed and needs to be reinsured.

Similar language penned by MacArthur and Meadows was key to the Obamacare repeal-and-replace legislation advanced by House Republicans last spring. However, the GOP push to pass comprehensive health care collapsed in the Senate.

MacArthur said he's currently focused on convincing Republican senators to support the stabilization measure, but he also hopes to reach out to Democrats. He said his goal is to have a proposal capable of passing the House and Senate ready for when lawmakers return to Washington next month.

"I'm trying to get a conservative senator and moderate senator, Republican senators, for starters, on board. And then we're going to try to get a House Democrat and Senate Democrat to sign onto this proposal," MacArthur said Tuesday night.

Ray Castro, senior policy analyst for left-leaning think tank New Jersey Policy Perspective, said funding the cost-share subsidies was critical, but he was concerned MacArthur might propose changes to weaken the ACA's insurance requirements.

"They're trying to hold (subsidies) hostage for their broader ideological goals," Castro said during a Wednesday conference call with New Jersey reporters. "Why not focus on what everyone agrees on rather than broader changes?"

Castro said time is short, as insurers will need some certainty about the subsidies early next month to avoid large premium increases.

Maura Collinsgru, health care program director for liberal advocacy group New Jersey Citizen Action, joined Castro on the call. She said Trump's rhetoric and actions to try to "sabotage" the law have created confusion in advance of the health care enrollment period, which begins Nov. 1 and runs until Dec. 15.

"It creates an extremely challenging atmosphere for consumers, and we expect the upcoming enrollment period, which has already been shortened to six weeks, will be very, very challenging," Collinsgru said.

She called on New Jersey officials to help direct consumers to obtain coverage and counter rhetoric claiming the law is a failure.

"This is not a failed experiment. The Affordable Care Act is and continues to be a lifeline for hundreds of thousands of New Jersey families," she said.

MacArthur and Meadows' stabilization plan isn't the only one making the rounds in Washington. A bipartisan group of House members, known as the Problem Solvers Caucus, has begun pushing a plan that also includes funding for cost-share reduction payments. The group's plan calls for repealing the ACA's medical device tax and raising the number of workers an employer must have before it is required to offer insurance from 50 to 500.

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