If passed in December, as opposed to before the Nov. 1 beginning of enrollment for 2018 Obamacare insurance policies, it would be unlikely to affect premiums for next year, meaning its benefits might not be felt until 2019. Insurers have already decided whether to participate in the Obamacare markets and set higher rates to build in the possibility that the subsidies would vanish.
Insurers say they do not profit from the subsidies, but pass them on directly to consumers to reduce deductibles, co-payments and other out-of-pocket medical expenses for low-income people.
The bill would also give more flexibility for states to offer a wider variety of health insurance plans while maintaining the requirement that sick and healthy people be charged the same rates for coverage.
Many Senate Republicans are nervous about the prospect of voting on any healthcare measure – no matter what legislation it may be attached to – that buttresses Obamacare.
Part of the fear, according to one senior Senate Republican aide, is that Trump’s former chief White House strategist Steve Bannon is recruiting hard-line conservative primary challengers to run against incumbent Republican senators next year. The aide said incumbents do not want to be forced to cast a controversial vote to stabilize Obamacare, a law reviled by many conservatives.
If all 46 Senate Democrats and two independents back the Alexander-Murray bill as expected, the support of the 12 Republicans means the bill has the 60 votes needed to reach the super-majority required to pass most legislation in the Senate.
Trump on Thursday underscored his concerns about the bill. He urged Alexander and Murray to be “careful with respect to the insurance companies,” which he said are “extremely talented at making money.”
Alexander and Murray both said that their legislation does not bail out insurers. Alexander also noted that House Republicans, in a Obamacare repeal and replace bill they passed in May, also would continue the subsidy payments for two years.
Alexander said Trump has called him four times in recent days on this subject, including a Saturday night call when he was at a restaurant and “my dinner got cold.” He urged the president to support the initiative.