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Senators Reach Bipartisan Deal To Stabilize ACA Insurance Markets


Just days ago, President Trump announced he is cutting off subsidies to insurers. These cost-sharing reduction payments under the Affordable Care Act allowed lower income Americans to get insurance more cheaply. The White House sees these subsidies as illegal bailouts for the insurance industry. But now, a bipartisan pair of senators, Republican Lamar Alexander and Democrat Patty Murray, say they have struck a deal to restore these subsidies for two years. And even though President Trump ended these payments, yesterday he sounded open to this.


PRESIDENT DONALD TRUMP: It is a short-term solution so that we don't have this very dangerous little period - including dangerous period for insurance companies, by the way. For a period of one year, two years, we will have a very good solution.

GREENE: Now, the goal here would be to stabilize the health insurance markets and make sure premiums don't soar. And one person watching this closely is Dr. Marc Harrison. He is CEO of Intermountain Healthcare, a hospital system and insurance provider in the state of Utah. Dr. Harrison, welcome back to the program. Thanks for coming on.

MARC HARRISON: Thanks. I really appreciate the opportunity, David.

GREENE: So I know this deal is a long way away from actually becoming law, but you find it encouraging.

HARRISON: You know, we really are encouraged. We particularly like the bipartisan effort. We like the fact that it gives a couple years to sort things out. You know, most importantly, we've really been very concerned about the very sick, the elderly and people who are just right on the bubble of being able to afford their insurance. And, you know, as a payer and a provider in a not-for-profit system that is both the largest payer and the largest provider in Utah and southern Idaho, these are our patients regardless, and we want them to stay insured.

GREENE: The president there called this a dangerous period - a dangerous little period I think were his words - for insurance companies like yours. What is - what is dangerous if these subsidies were cut as the president's talked about?

HARRISON: So the real danger is not to the insurance companies. The real danger is to the patients. So in the absence of coverage, they don't get their chronic care. They end up in emergency departments. They put things off until they go from being routine to very serious. And I'm actually concerned that when people lose coverage, people are going to die unnecessarily, and they're going to suffer unnecessarily.

GREENE: And you think that this solution from these two senators, I mean, as I think they have said, it would prevent chaos. I mean, is this really a solution that will serve your customers and make you feel confident that that situation won't transpire?

HARRISON: Well, I think it's a great start. And, you know, I've never said that the ACA was perfect, and I think there's a lot of work that needs to go on, but I think this would be - this would go a long way to getting us started to having a period of stability. I will also say that, you know, the Trump administration cut the enrollment period for the ACA from 12 down to six weeks, and I would strongly, strongly recommend that the Congress extends that period outward again to give people a chance to know that they actually can get covered and to enroll. And the other thing that got slashed was the navigator program, which helps people, often people who are not incredibly sophisticated, try and understand what the best product is for them. And that program was slashed by 90 percent. So I'd encourage the Congress to reinstate both the longer enrollment period and funding to the navigator program.

GREENE: All of this a reminder of the uncertainty that you have been dealing with, it seems like, as the political back and forth happening in Washington. How have you been dealing with that?

HARRISON: Maybe I'm not very deep, David, I stick to the basics. So what can we control? We control access, quality, and we keep our costs as absolutely low as possible. And so that's - we have our team who's absolutely entirely focused on the patient and meeting those fundamentals.

GREENE: Dr. Marc Harrison is the CEO of Intermountain Healthcare in Utah. Dr. Harrison, thanks for your time.

HARRISON: Hey, it's a privilege. Thank you.

GREENE: And our national political correspondent, Mara Liasson, was listening to that conversation. Hi, Mara.


GREENE: So let's talk about the reality on Capitol Hill and in Washington. He sounds fairly optimistic that maybe this deal could go through, but we've seen Republican health care measures fail recently. What - where could this deal be going?

LIASSON: Well, based on our experience, I don't think anybody should bet a whole lot of money on this bipartisan deal being passed by Congress. There already has been pushback from conservative Republicans, especially in the House, saying they've been voting for seven years to repeal and replace Obamacare. And this would not repeal it. This would stabilize it and continue it for about two years. So there has already been pushback from this, even though the president, as you played earlier, gave it a tentative endorsement. I think it's going to be tough for this to pass Congress.

GREENE: And what do you make of what we're hearing from the president? I mean, he's been adamant about wanting to repeal Obamacare. Now he seems, as you said, to be tentatively supporting this measure, which in effect would shore it up. Make sense of that for us, if that's possible.

LIASSON: Well, it's hard - no, I can't make sense of it because the other day when he said that he was going to discontinue the subsidies - he called them bailouts to insurance companies - he said that they were a really bad idea. Now, he says that it's - he's OK with having these subsidies continue temporarily for two years, in which time he says that the votes would be collected for the long-term permanent solution, which would be to block grant Obamacare to resurrect the Graham-Cassidy bill that failed in the Senate. So I can't really make sense of it except for maybe he doesn't want to be blamed for the chaos and collapse of the exchanges.

GREENE: NPR national political correspondent Mara Liasson. Mara, thanks.

LIASSON: Thank you. Transcript provided by NPR, Copyright NPR.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Mara Liasson is a national political correspondent for NPR. Her reports can be heard regularly on NPR's award-winning newsmagazine programs Morning Edition and All Things Considered. Liasson provides extensive coverage of politics and policy from Washington, DC — focusing on the White House and Congress — and also reports on political trends beyond the Beltway.