Senate passes spending bill without insurance stabilization; Trump signs after threatening veto

The Senate passed a $1.3 trillion spending appropriation early this morning, but not without two last ditch efforts to include health insurance stabilization measures for cost-sharing reduction payments and a reinsurance program.

Neither stabilization proposal by Republican Senator Susan Collins of Maine or Democrat Patty Murray of Washington State went through in the bill approved in a 65 to 32 vote. The House passed the bill earlier yesterday, 256-167.

Without CSRs or reinsurance, insurers are expected to increase premiums in the individual market of the Affordable Care Act as they start to set rates for October, though yesterday on her website, Murray said she hoped legislators could go back to the table to resume bipartisan talks.

President Donald Trump signed the bill, averting a government shutdown tonight, after tweeting this morning, "I am considering a VETO of the Omnibus Spending Bill based on the fact that the 800,000 plus DACA recipients have been totally abandoned by the Democrats (not even mentioned in Bill) and the BORDER WALL, which is desperately needed for our National Defense, is not fully funded."

Had stabilization measures passed, premium rates would have been reduced by up to 40 percent, according to Republican Senator Lamar Alexander of Tennessee.

For the past seven months, Alexander and Murray, the respective chairman and ranking member of the Senate Health, Education, Labor and Pensions Committee, have been working on a bipartisan measure to stabilize the ACA market and reduce premiums.

An agreement had been reached on the Bipartisan Health Care Stabilization Act of 2018, but at the last minute, Republicans included "poison pills" they  knew Democrats would never agree to, Murray said.

The language went beyond that of the Hyde Amendment to prevent federal funds from going to any insurer offering abortion coverage, according to Murray.

"I understood current conditions for abortions would apply," Murray said. "This isn't what it is."

There is a divide on how the language could be read and applied, she said.

"Women couldn't even buy abortion coverage using their own money," Murray said. "I would not allow women's productive freedoms to become a political football."

Alexander said Democrats have approved the same language in the Hyde Amendment to 100 other federal programs, including to the National Institutes of Health, community health centers, federal family grants and employee health benefits programs.

"The Hyde language has applied since 1976," Alexander said. "All we want to do is to apply to this health program (the same thing) they've applied to every other health program. On this issue we've reached an impasse."

Republican Senator Susan Collins of Maine urged for passage of a stabilization measure she had put forward with Democratic Senator Bill Nelson of Florida.

Starting next month, Collins said, insurers will be starting their calculations on what the rates will be and whether to sell individual coverage in markets across the nation.

"Make no mistake about the stakes here," Collins said. "If we do not act insurance rates will go up on October 1 …"

Murray objected to the Collins-Murray plan and instead put forward her own amendment.

Senate Majority Leader Mitch McConnell objected to Murray's proposal.

"This has been a very disappointing moment," he said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com