(Bloomberg) — Senate Republican leaders are considering a proposal by Sen. Ted Cruz that would allow insurers to sell cheaper, less robust plans as long as they also sell policies that meet coverage standards imposed by the Affordable Care Act.
The Texan’s idea is aimed at breaking the health care logjam and winning conservative holdouts — but the proposal faces opposition from the moderate wing, underscoring the delicate balance facing party leaders trying to secure the votes for a bill to unwind the Affordable Care Act.
Third-ranking Republican Sen. John Thune of South Dakota kept the door open Thursday to adding Cruz’s proposal to the Senate’s Better Care Reconciliation Act bill, saying that “there’s some value” to the policy when it comes to “giving people more options and more freedom to get the policy that they want.”
“Obviously, it has to be structured in a way that ensures that the pools aren’t adversely affected,” he said. “There was some discussion yesterday about ways in which you could incorporate that.”
Sen. John Barrasso of Wyoming, a physician and member of GOP leadership, also said the Cruz proposal is under discussion, but wouldn’t say if it’ll be adopted.
The idea seeks to satisfy Cruz’s overarching goal in a health care bill: to lower premiums. He and other conservatives argue that the strict insurance rules under Affordable Care Act, aimed at protecting sick people, have driven up costs for young and healthy people who they believe should have the option of buying relative inexpensive plans — even if they would cover fewer medical services.
But critics worry the idea would lead to skyrocketing costs for sicker people and those with preexisting conditions by steering healthier people into a separate pool. And the proposal isn’t going over well with moderate Republicans, who worry it would effectively gut rules designed to protect patients.
“It would lead to adverse selection in the marketplace, and it would vitiate the important consumer protection of having a prohibition against annual and lifetime caps,” Sen. Susan Collins of Maine said in an interview.
Sen. Rob Portman of Ohio expressed some hesitation with Cruz’s idea, saying it’s important to him that pre-existing conditions are protected. He said the proposal is still being fleshed out.
Cruz has been meeting with Senate Majority Leader Mitch McConnell of Kentucky, as well as Republicans like Bill Cassidy of Louisiana and Portman, to discuss the idea. Cruz is so intent on lowering premiums, said a person familiar with his thinking, that he’d be willing to compromise in other areas if he’s convinced the bill will would do that.