Sen. Lamar Alexander, R-Tenn. (Photo: Alexander)

Senators are nearing a deal on a bipartisan package to help stabilize the Affordable Care Act public health insurance exchange system.

Republican Sen. Lamar Alexander of Tennessee told reporters that he and his Democratic colleague Patty Murray of Washington are close to an agreement, but the real issue now is securing the backing of leaders from both parties and enough senators to move forward.

“It’s not a matter of just whether Senator Murray and I can agree,” Alexander said. “It’s a matter of whether she and I can find consensus among Republicans and Democrats that we believe can be enacted into a result.”

(Related: Lamar Alexander Puts Bipartisan ACA Repair Bill Back in Play)

Alexander and Murray’s effort is complicated by the continued presence of the Graham-Cassidy-Heller-Johnson bill, a bill to repeal parts of the Affordable Care Act that failed to garner enough Republican support to pass this week ahead of a Saturday deadline. Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, who authored the latest repeal effort, met Thursday with President Donald Trump to discuss a plan to revive the legislation in the coming months.

“Over the coming weeks and months, we are committed to holding congressional hearings and working with our nations’ governors who believe returning power to states is a vast improvement over Obamacare,” Graham and Cassidy said in a joint statement.

Until the now-failed Graham-Cassidy bill gained steam, briefly, Alexander and Murray had been working on a small bill to fund subsidies for insurers to lower Americans’ health costs and provide states with more ability to adjust ACA health insurance rules. It’s unclear whether the restarted bipartisan effort will eventually be able to gain necessary support. Trump and House Speaker Paul Ryan have both indicated they wouldn’t support such a bill.

Sen. John Cornyn of Texas, the No. 2 Republican leader, said he was upbeat about the emerging Alexander-Murray deal because the two are discussing offering added flexibility to states.

‘Real Reform’

“I’m encouraged that it’s more than just providing additional subsidies to insurance companies,” he said. “It looks like some real reform that’s part of it.”

He said that includes the ability to offer “copper,” or catastrophic, plans. Today, under the current ACA rules, most people who want to use an individual or family policy to avoid the ACA penalties on the uninsured must have a policy that covers at least about 60% of the actuarial value of the “essential health benefits” package, or standard benefits package. A copper plan could cover just 50% of the actuarial value of the EHB package.

The agreement Alexander and Murray are crafting is expected to seek to stabilize the ACA exchange system and states’ individual major medical insurance markets over the next few years.

Senate Minority Leader Chuck Schumer of New York was optimistic on the floor of the chamber that Alexander and Murray were “on the verge” of a deal.

“I would hope it is a great start on bipartisanship” on other issues that are coming up, Schumer said, adding that he had spoken about the matter with Alexander this morning in the Senate gym.

Still, Republicans have already signaled they will attempt yet another revival of their repeal efforts after dealing with a tax overhaul. Trump has “fully committed the administration to continue working” to pass the measure sponsored by Graham and Cassidy, the two senators said in a statement Thursday.

Plowing Ahead

Graham also projected optimism on Thursday following what he described as an “awesome” meeting with Trump. Graham and Cassidy had attempted to get enough support for a vote just a few days after introducing it Sept. 13 — and after holding only one hearing.

“We are working very closely with the president and his team to plow ahead,” Graham said. “I really do believe we will have the votes for the better process,” he added. “Truth of the matter is it’s not a substantive issue, it’s a process issue.”

The Graham-Cassidy bill would make major changes to Affordable Care Act starting in 2020, including using the money that funds the law to dole out block grants to states to use how they see fit to provide health care coverage for their residents.

—With assistance from Timothy Annett and Ari Natter.

— Read GOP Pledge to Torch Obamacare Veers Toward Bare-Bones Repeal on ThinkAdvisor.


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