Republicans are starting to reconsider reinsurance.
Faced with the prospect that they might be blamed for big increases in health insurance premiums in the weeks before the November elections, GOP leaders in Congress and in a number of states are trying to put in place the type of reinsurance programs that they fought to dismantle in the past.
President Trump's budget included $800 million to fund the Affordable Care Act risk corridor program, which was largely crippled by a budget deal in 2015. While Congress is viewing the president's budget as a symbolic document that will unlikely be approved in whole, the inclusion of risk corridors suggests Trump would be willing to sign a separate bill aimed at shoring up the ACA marketplace.
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A bipartisan bill in Congress, sponsored by Reps. Ryan Costella, R-Penn., and Collin Peterson, D-Minn., would put billions of dollars into reinsurance. A companion bill in the Senate has been proposed by Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla.
Collins has said that Majority Leader Mitch McConnell, R-Ky., has promised her to allow a vote on the bill in the Senate. McConnell reportedly made the commitment in exchange for Collins' vote on the tax bill in December.
Similarly, in Wisconsin, Gov. Scott Walker, facing re-election in November, has proposed a $200 million reinsurance fund for ACA plans in the state. He has framed the proposal as a way to mitigate the health law's "failures."
In fact, the ACA originally included a large reinsurance program that was severely hobbled by a provision snuck into a 2015 budget deal by Sen. Marco Rubio, R-Fla. The then-presidential candidate boasted that he had stopped the "bailouts" of insurance companies.
As a result of the Rubio provision, insurers received dramatically less money through the reinsurance program than anticipated. A number of non-profit cooperative health plans blamed the attack on the program for their collapse.
Rubio has pushed back against the attempt to reinstate reinsurance funds. In tweets earlier this week, he blasted the reinsurance provision of the president's budget, saying that he had "been fighting for years to ensure we do not bail out Obamacare."
Other conservative forces will likely push against what they view as another surrender on Obamacare.
"They shouldn't demand repeal for eight years and then suddenly decide it's wise to bail out the very program they claim to detest," Andy Roth, a lobbyist for the conservative Club for Growth, tells the Wall Street Journal.
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