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Two Republicans have increased the odds that the current Affordable Care Act health insurance framework will survive.
The Republicans — Rep. Kevin Kiley, R-Calif., and Rep. Don Bacon, R-Neb. — backed a bill introduced by Rep. Sam Liccardo, D-Calif., — that could keep a high level of individual major medical insurance premium subsidies in place for at least two years.
Kiley said in the bill introduction announcement that the measure could protect millions of consumers from huge, sudden increases in health coverage costs.
"This will provide short-term relief while we tackle broader reforms to lower the cost of care," Kiley said.
The introduction of the bill comes as President Donald Trump has seemed to signal that he is sympathetic to Republicans who want to send health coverage purchase cash straight to consumers, rather than shoring up the current ACA subsidy system.
But, in the past, Trump has suggested that he was sympathetic to the idea of keeping the ACA system in place while policymakers develop a better alternative.
The Fix It Act bill: Liccardo has proposed holding down the cost of keeping a high level of subsidies in place by limiting access to subsidies to people with income under 600% of the federal poverty level, or $192,900 for a family of four in most of the country.
Today, consumers at any income level can get premium subsidies if the cost of standard health coverage exceed more than about 10% of their income.
Liccardo has called for offsetting part of the cost of providing the extra subsidies by fighting efforts by health insurers to qualify for extra Medicare Advantage subsidy money by making enrollees look as sick as possible.
Liccardo also wants to raise money by imposing fines on brokers who help consumers get extra ACA premium subsidies by violating ACA coverage enrollment rules.
The policy backdrop: Analysts who are popular with Republicans have argued that the current high level of premium subsidies has increased the cost of individual health coverage too much while leading to expensive, heavily subsidized individual coverage crowding out small-group coverage.
Some Republicans say Congress should come up with a strategy for helping people keep their health coverage and protecting the current ban on medical underwriting in the individual major medical market before changing the subsidy levels.
KFF recently reported that 94% of the Democrats it has surveyed since Oct. 27, 76% of the independents and 50% of the Republicans supported extending the current subsidy levels.
What it means for employer health plans: The introduction of a bipartisan ACA subsidy bill suggests that the battle over the fate of the ACA subsidy system is still in progress.
In the short term, uncertainty could lead to uncertainty among insurers, health care providers and others.
The uncertainty could push some health care providers to lock in deals with employer plans as quickly as possible, but it could cause insurers and other players to put off completing deals with employers as long as possible.
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