Today, Congressmen Tom Reed (NY-23) and Josh Gottheimer (NJ-5), Co-Chairs of the Bipartisan Problem Solvers Caucus announced the Caucus reached consensus over the weekend on a bipartisan set of solutions to stabilize health insurance markets and provide relief to individuals, families and small businesses.
After much work, the 43 Republicans and Democrats delivered a set of principles to advance solutions to address the destabilized individual healthcare market. These bipartisan proposals focus on areas they can find broad consensus to work together to stabilize the healthcare industry.
By resetting the healthcare conversation in Congress, the Problem Solvers Caucus has set the stage for the kind of bipartisan solutions that Americans have been yearning for. The Caucus hopes to restore some predictability as insurance companies make decisions about premium prices in 2018.
Bipartisan Problem Solvers Caucus Proposal to Stabilize the Individual Market (click to view)
It is clear that the individual health insurance market is deteriorating in some areas of the country and we must act quickly to stabilize it. We all agree that the individual market needs restructuring, and we should swiftly implement changes in time to take effect for insurance plans offered for 2018. Committees of jurisdiction should begin to address the issue through regular order.
To stabilize the individual market and provide some immediate relief, we propose exploring realistic solutions including the following:
1. Bring cost-sharing reduction (CSR) payments under the Congressional oversight and appropriations process, but ensure they have mandatory funding. CSR payments are an important part of helping households earning between 100% and 250% of the federal poverty level afford to participate in the individual market. Bringing CSR payments under the appropriations process ensures that Congress can provide proper oversight.
2. Create a dedicated stability fund that states can use to reduce premiums and limit losses for providing coverage—especially for those with pre-existing conditions.
3. Adjust the employer mandate by raising the threshold on the requirement for employers to provide insurance under the employer mandate to businesses of 500 employees or more. The current employer mandate places a regulatory burden on smaller employers and acts as a disincentive for many small businesses to grow past 50 employees. Additionally, the definition of “full time” under the employer mandate should indicate that a full-time work week is 40 hours.
4. Repeal the medical device tax. This tax adds a 2.3% sales tax on medical device supplies. The costs of the tax are passed on to consumers and it should be repealed.
5. Provide technical changes and clear guidelines for states that want to innovate on the exchange or enter into regional compacts to improve coverage and create more options for consumers.
● Section 1332 of the ACA allows states to innovate and share in health savings while offering strong plans with all essential health benefits. Some states have begun to experiment in this regard, with great potential for success. However, some technical legislative changes and/or revised HHS guidance may improve attractiveness to additional states.
● Similarly, Section 1333 of the ACA allows states to enter into Health Care Choice Compacts, which allow insurers to sell across state lines in participating states. However, HHS has not yet released regulations on Section 1333. HHS should issue clear guidelines and work with states to spur innovation and bring more choice and competition to the market while protecting consumers.
We must continue to explore additional ways to improve patient choice and responsibility, create positive incentives for providers to lower costs, and enhance state flexibility. During the August work period we will meet with constituents and stakeholders and will return to Congress ready to take action.
We believe that this proposal should be paid for. We stand ready to work to find agreeable offsets within federal health care spending.
“The last great hope for this country is that Republicans and Democrats prove they can work together,” said Problem Solvers Caucus Co-Chair Tom Reed. “We’ve locked arms to continue the fight for the American people, their families and their healthcare. Today, we are proud to deliver a set of bipartisan solutions to move health coverage forward so that our fellow Americans can also move ahead with restored hope in their own future and in the ability of Congress to resolve critical issues. We as a Caucus, will continue to work together with bipartisan dignity and commitment to the American people, who deserve stable healthcare and a functional Congress.”
“For too long, health care has been viewed as a fiercely partisan battleground, but the Problem Solvers Caucus has shown that it is possible to forge cooperation and fight through the gridlock. We all heard what John Mccain said -- it's time for bipartisan solutions,” said Problem Solvers Caucus Co-Chair Josh Gottheimer. “And with premiums increasing by 25% this year in my home state of New Jersey, it’s clear this bipartisan effort to stabilize the health insurance marketplace and lower premiums for everyone is sorely needed. This plan will help small businesses and families, especially those with preexisting conditions, by making permanent cost sharing reductions while protecting Medicaid for seniors and those struggling with substance abuse disorders. I thank my colleagues for their hard work and good faith efforts that got us to this point, and I look forward to working with them going forward to improve our health care system.”
Members of the Problem Solvers Caucus further voiced their support:
"The country is fed up with partisanship and politics taking precedence over real solutions to the problems we are facing, especially in health care. Right now we have serious problems in our individual health care marketplace that both sides recognize. Let's deal with them! Continued uncertainty will put that market into a death spiral. My colleagues and I in the Problem Solvers bipartisan caucus have listened to experts, insurers and providers to come up with a simple straightforward revision to the ACA to make sure 20 million Americans still get affordable health care without facing exponential increases in premiums or deductibles. Rank and file Democrats and Republicans are willing to work together to solve some of America's toughest problems. Please join us." - Rep. Kurt Schrader (OR-5)
“Many of us on both sides of the aisle came here to solve problems and get things done. And I always talk about how I make my decisions based on facts and working towards objectives that are achievable. While there is a lot of attention on areas of disagreement on healthcare, I am always trying to find areas of agreement. It doesn’t take a doctor to diagnose that the individual market across the country is not healthy and urgent action is needed to help our constituents. For the last several weeks, members of the Problem Solver Caucus have been rigorously working on solutions we can agree upon to stabilize it and provide relief to families and small businesses. I am honored to have been a co-leader in that effort. I hope our efforts and ideas can shift the discussion at this point and provide a basis for solutions going forward.” - Rep. Martha McSally (AZ-2)
"This is a starting point for bipartisan solutions to stabilize the individual insurance market, keep Americans covered, and slow the rise of premiums and deductibles. We all acknowledge there are parts of the Affordable Care Act that need to be fixed and parts that need to be protected, and we are putting party politics aside to get to work. Even on an issue as contentious as health care, in an atmosphere as partisan as D.C., we have found this common ground that we can build from." - Rep. Scott Peters (CA-52)
“It is time to set aside the purely partisan approach on health care and work together to enact durable and sustainable reforms for the American people. I am proud to join my colleagues, Republican and Democrat, in taking an important first step to demonstrate that we can work together to improve our health care system.” - Rep. Charles W. Dent (PA-15)
"Americans are desperate for Democrats and Republicans to work together to try and tackle the challenges our country faces. The Problem Solvers Caucus, by proposing this major bipartisan first step, is like an oasis in a desert of dysfunction. We still have much more to do with health care and other issues and we hope our colleagues will join our efforts in this spirit of goodwill and compromise for the common good." - Rep. Tom Suozzi (NY-3)
“The path forward to fixing the healthcare mess is seeking bipartisan, common-sense common-ground. At the top of our list is stabilizing insurance markets and ensuring lower premiums for patients. Our other goals are simple and what I’ve fought for all along: Protect those with pre-existing conditions and ensure states that expanded Medicaid, like Michigan, are secure. This will safeguard the most vulnerable amongst us so they do not have the rug ripped out from under them. I look forward to being a constructive, bipartisan partner in these efforts. To that effect, I have joined with nearly 50 members of both parties as part of the bipartisan “Problem Solvers” caucus to pursue these goals.” - Rep. Fred Upton (MI-6)
“The American people are tired of the status quo in Washington. They want their Representatives to work together to solve problems, and that is what the Problem Solvers Caucus has done with this bipartisan plan that will take the steps that everyone agrees are needed to stabilize the individual health insurance market and lower premiums. The purpose of this plan is not to solve all the issues with the ACA, but to take commonsense steps that will make it work better. We have proved that it is possible for a large group of Democrats and Republicans to sit down and develop a compromise on healthcare that is good for the American people. I am hopeful that the rest of Washington sees what the Problem Solvers have done and can come together for the good of the country.” - Rep. Dan Lipinski (IL-3)
“I’m glad to be part of a bipartisan group of House members working together to pick up the pieces of the Senate’s failed attempts to address the failures of Obamacare.”- Rep. Lloyd Smucker (PA-16)
"The only way to improve health care outcomes for Americans is through bipartisan compromise. This point has been made clear over the previous six months of debate. I am eager to work across the aisle to advance health care proposals that improve upon the gains we have made." -Rep. Jim Costa (CA-16)
”The American people rightfully expect Republicans and Democrats to come to the table and work together to find meaningful solutions that will improve our health care system and lower medical and insurance costs for all. The Problem Solvers Caucus is at the forefront of this effort and I am proud to be a part of it." – Rep. Leonard Lance (NJ-7)
“The voters in my district sent me to Washington to engage in a constructive, deliberative process to address our nation's challenges. The work of the Problem Solvers Caucus is a first step, showing that when people come together with open minds, ideas and a willingness to work together, progress is indeed possible.” - Rep. Brad Schneider (IL-10)
“It is our job to navigate the complexities of this issue on behalf of the American people in a bipartisan manner.” - Rep. Glenn “GT” Thompson (PA-05)
"As Chairman of the solutions-oriented New Democrat Coalition, I am extraordinarily pleased by this exercise. More than a statement of policy, this collection of ideas shows that Democrats and Republicans can work together on even the most challenging of topics to make progress." - Rep. Jim Himes (CT-4)
"It's critical to our democracy for Members of Congress to put politics aside and come together to find solutions to the issues affecting our constituents. Our healthcare system needs reform and I've been committed to working with colleagues on both sides of the aisle to find market-based solutions that would result in increased coverage and lower costs. Together with my colleagues in the Problem Solvers Caucus we are committed to working toward compromise and consensus that can move the conversation forward.” - Rep. Carlos Curbelo (FL-26)
“The insurance coverage crisis is a looming healthcare disaster for millions of Americans, and I am proud to join my colleagues in supporting bipartisan solutions to bring down costs and keep coverage options accessible.” - Rep. John J. Faso (NY-19)
"Task one is to stabilize the insurance marketplace this year for all Americans. We need to ultimately implement sustainable reforms to improve our healthcare system, and it needs to be anchored from the ideological center in order to pass both chambers of Congress and have the confidence of the American public. That's the reality as I see it, I think a broad cross-section of my constituents and Americans agree, and that's how I intend to help lead this effort." -- Rep Ryan Costello (PA-06)
Rep. Adam Kinzinger (IL-16), also a member of the Caucus, agreed.
(To view proposal: https://drive.google.com/file/d/0BzGrAsu82Hmpc3g5OUxHRndjTGRVRUluNFFJNndBSklTRFpv/view?usp=sharing)