The White House signaled to Senate Republican negotiators Friday that they want to include retroactive relief this year for both individuals and employers subject to the Affordable Care Act’s insurance mandate in a bipartisan health bill, according to individuals briefed on the matter, a request that is sure to anger Democrats.
Key White House officials are hoping to shift to the right the proposal crafted by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., which would restore subsidies to help offset out-of-pocket costs for low-income Americans buying ACA plans in exchange for further flexibility in how states regulate health coverage.
The individuals briefed on what the White House privately signaled to Senate Republicans were granted anonymity to describe closed-door talks that had not been announced publicly. They said that the nothing was final and that the negotiations were ongoing and could change rapidly.
While the moves were part of what could become a more extended negotiation, the White House requests – which also include providing states with broader leeway – would derail the carefully crafted bipartisan package unveiled this week.
The move to suspend federal enforcement of the current insurance mandates is an anathema to Democrats, who view the requirements as integral to the law’s success. All taxpayers must now provide proof of insurance coverage or face a penalty: the current fine is $695 per adult and $347.50 per child – up to $2,085 per family – or 2.5 percent of family income, whichever is greater. Employers with 50 or more full-time equivalent employees that don’t offer coverage face a fine of $2,260 divided by 12, times the number of total full-time employees minus 30. These businesses also face a fine if federal officials determine the plans they offer are either unaffordable or don’t provide adequate coverage.
The White House declined to comment immediately. In a statement, Alexander said, “This is the normal legislative process with people of different views saying what they are for and against. Something close to the Alexander-Murray proposal is likely to become law this year because the President himself asked us to develop this short-term solution so people aren’t hurt by a chaotic insurance market.”
In a statement of his own, Senate Minority Leader Charles Schumer, D-N.Y., said, “The administration was involved in the Alexander-Murray negotiations every step of the way. There is a broad bipartisan agreement that can pass the Senate right now. The administration should support it instead of floating other ideas that would further the sabotage both parties are trying to reverse.”
Insurers have described these mandates as critical to ensuring that enough healthy people buy coverage, which in turn translates into a broader risk pool. The Congressional Budget Office has estimated that repealing the individual mandate this year would translated into 15 million fewer insured Americans by 2026, though several experts have questioned whether this requirement provides as powerful an incentive to sign up as the CBO has consistently estimated.
According to the Internal Revenue Service, 6.5 million taxpayers paid $3 billion in ACA penalties for not having insurance in 2016.
(c) 2017, The Washington Post · Juliet Eilperin, Sean Sullivan