Movement on healthcare repeal and replace efforts in the Senate have dramatically slowed. The Republican working group is moving forward with its meetings but making little progress, other than clarifying its goal to lower premiums. The working group members include:

  • Mitch McConnell (R-Ky.), majority leader
  • John Cornyn (R-Texas), majority whip
  • John Thune (R-S.D.), chairman of the Senate Republican Conference
  • John Barrasso (R-Wyo.), chairman of the Senate Republican Policy Committee
  • Orrin Hatch (R-Utah), chairman of the Senate Finance Committee
  • Lamar Alexander (R-Tenn.), chairman of the Senate Health Committee
  • Michael Enzi (R-Wyo.), chairman of the Senate Budget Committee
  • Tom Cotton (R-Ark.)
  • Cory Gardner (R-Colo.)
  • Rob Portman (R-Ohio)
  • Patrick Toomey (R-Pa.)
  • Ted Cruz (R-Texas)
  • Mike Lee (R-Utah)

Meanwhile, a second working group began meeting this week with the intention of finding a bipartisan solution to the AHCA. That group, led by Senators Bill Cassidy (R-La.) and Susan Collins (R-Maine), includes:

  • Joe Manchin (D-W.V.)
  • Joe Donnelly (D-Ind.)
  • Heidi Heitkamp (D-N.D.)
  • Shelley Moore Capito (R-W.V.)
  • Lindsey Graham (R-S.C.)
  • Dan Sullivan (R-Alaska)

The only clarity being made public from their initial conversations is that they believe a moderate, bipartisan solution would be a better approach for the Senate.

Education Efforts Continue on Council Priorities

Our efforts to educate Senators on the strengths of the employer-sponsored insurance market and the corresponding tax exclusions continue. Taxing insurance premiums is very much on the table in Senate negotiations, and we’re working to ensure that the Senate understands the impact that taxing premiums could have on coverage rates.

It is rumored that inclusion of a 10 percent premium tax in the original ACHA House draft resulted in a CBO score that suggested an additional 10 million Americans would lose coverage because of the provision.

The timeline for Senate action remains tricky. Any Senate bill that differs from the House version would have to either be conferenced with the House bill, or receive House approval. Considering the significant differences that look to come out of any Senate bill, a conference between the two bills would have to occur. Procedurally, each chamber would then have to approve the final version that is negotiated in the conference committee.

Recalling the tug of war that Speaker Ryan had with moderates and conservatives in his caucus, it is difficult to see the iteration of controversial provisions that would thread the needle for House politics, particularly regarding state waivers on pre-existing condition rules, Medicaid expansion issues and subsidy reductions.

That debacle increases the pressure on the bipartisan working group to find common ground on issues that be able to generate Democratic support in the House. It’s an unlikely coalition, but in this era, anything can happen.

Joel Kopperud, Vice President, Government Affairs:

Cheryl Matochik, Senior Vice President, Strategic Resources & Initiatives:

Michael Kanick, Digital Marketing Strategist: