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July 31, 2017

'Repeal and replace' isn't dead yet: Trump meets with key senators on new proposal

Daily Briefing

Republican Sens. Bill Cassidy (La.), Lindsey Graham (S.C.), and Dean Heller (Nev.) met with President Trump on Friday to discuss whether a health reform proposal offered by Graham could be a viable path forward for Republican lawmakers to repeal and replace the Affordable Care Act (ACA).

Why investing in consumer loyalty is a no-regrets strategy—no matter what happens with the ACA

The meeting comes after Senate Republicans last week failed to advance three separate measures that would have partially repealed the ACA. According to Politico, Trump has urged Senate Republicans not to give up on trying to repeal the health reform law.

Graham's proposal

Graham's proposal—which Cassidy and Heller have signed on to support—would keep most of the ACA's taxes in place and "redirect much of the current federal funding" for the ACA to states via block grants, according to a release. In addition, the proposal would:

  • Eliminate the ACA's medical device tax; and
  • Repeal the ACA's individual and employer mandates.

According to the release, the measure would keep in place the ACA's protections for individuals with pre-existing medical conditions.

The Congressional Budget Office has not scored Graham's proposal.

Graham in a statement on Friday said, "Trump was optimistic about the Graham-Cassidy-Heller proposal," adding, "I will continue to work with ... Trump and his team to move the idea forward."

Stakeholders look for compromise in the House

In addition, White House officials on Friday met with House Freedom Caucus Chair Mark Meadows (R-N.C.) to discuss health reform measures that could get support from conservative House lawmakers.

Caucus members on Friday criticized Senate Republicans' failure to advance an ACA repeal measure and called on senators to delay leaving for their upcoming August recess until they make progress on a health reform bill, Politico reports.

Likewise, House Speaker Paul Ryan (R-Wis.) said he was "disappointed and frustrated" with the stalled effort in the Senate. He added, "I encourage the Senate to continue working toward a real solution that keeps our promise" to repeal the ACA.

According to Politico, Graham has spoken with Meadows about how to gain support for his proposal in the House, and Meadows indicated the proposal could need some changes to appease House conservatives. Meadows added that he also is considering a proposal offered by Republican Sens. Ted Cruz (Texas) and Rob Portman (Ohio) that would overhaul the ACA's subsidies and create a fund to help states keep their insurance markets stable. Overall, Meadows said, "I'm still optimistic that we will ... ultimately put something on [Trump's] desk."

Some lawmakers call for bipartisan efforts

Meanwhile, some lawmakers are calling for bipartisan health reform efforts.

Senate Minority Leader Chuck Schumer (D-N.Y.) on Friday said he hopes Democrats and Republicans in the Senate now "can work together in a bipartisan way" on health reform, adding, "I'm optimistic that ... can happen."

Schumer detailed some priorities Democrats have for health reform, saying, "I think at the very beginning we should stabilize the system" by:

  • Addressing low insurer participation in some exchange markets;
  • Creating a reinsurance program; and
  • Ensuring the federal government will continue making cost-sharing reduction payments to insurers.

Then, lawmakers "should sit down and trade ideas," Schumer said.

Further, a bipartisan group of more than 40 House lawmakers on Monday unveiled a five-prong plan intended to bolster the ACA, The Hill reports.

The proposal would:

  • Create a so-called "stability fund" that states could use to help offset consumers' premium costs, particularly for individuals with pre-existing medical conditions;
  • Exempt businesses with 500 or fewer employees from the ACA's employer mandate, up from the ACA's current exemption for businesses with 50 or fewer employees;
  • Give states more flexibility to implement polices intended to expand consumers' coverage options and reduce costs, such as making it easier for insurers to sell health plans across state lines;
  • Provide mandatory funding for the ACA's cost-sharing reduction payments to insurers; and
  • Repeal the ACA's medical device tax.

Rep. Tom Reed (R-N.Y.)—co-chair of the Problem Solvers Caucus, which released the proposal—said, "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." He added, "We as a caucus, will continue to work together with bipartisan dignity and commitment to the American people, who deserve stable health care and a functional Congress" (Lillis, The Hill, 7/31; Jackson, USA Today, 7/31; Rep. Lloyd Smucker (R-Pa.) release, 7/31; Everett et al., Politico, 7/29; Sullivan, The Hill, 7/28; Graham release, 7/13; Nelson, Politico, 7/28; McPherson/Rahman, Roll Call, 7/28; Bowman, Roll Call, 7/28).

Why investing in consumer loyalty is a no-regrets strategy

Health systems can strengthen relationships with patients by offering consumers a return on their investment in loyalty, such as health motivating rewards, direct-to-consumer memberships, or value-based insurance design models.

Join us on Friday, August 4 at 1 p.m. ET to learn how to generate consumer loyalty and why investing in loyalty is a no-regrets strategy regardless of business model—and no matter what happens with the ACA.

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