Bill Cassidy Is Ready To Cut A Deal On Obamacare

Sen. Bill Cassidy said he is open to a compromise with Democrats to temporarily extend the enhanced Obamacare subsidies – especially if it includes elements of his own plan – until conservative reforms can be made.

“That may be the sweet spot, where we actually have a short term extension, but we allow the patient to take that subsidy and put it into a health savings account, as opposed to just getting stuck with a $6,000 deductible,” said the Republican chair of the Health, Education, Labor and Pensions Committee, referring to the highest deductible for a silver tier plan.

But Cassidy also said he wants his party to put forward their own bill when the chamber votes Thursday on a Democratic proposal to extend Obamacare subsidies, he said at the “POLITICO Policy Outlook: Health Care Affordability” event on Tuesday.

Cassidy touted the legislation he’s proposed with Sen. Mike Crapo (R-Idaho), who chairs the Finance Committee, which would create government-funded health savings accounts to replace enhanced Obamacare subsidies that expire after this year.

Cassidy argued that his plan, which would give Americans money to pay for part of their deductible when they seek health care services, is superior to the Democrats’, which the Republican senator argued would maintain the status quo and is too expensive.

His proposal is one of many Republicans have put forward. But two days before a high-profile vote on the Democratic proposal to extend expiring Obamacare subsidies, GOP senators haven’t united behind any single alternative that could be put up alongside it.

Cassidy, who released his legislation Monday, said he believes President Donald Trump supports it. He also said he’s talking to Democrats like Problem Solvers Caucus Vice Chair Josh Gottheimer, a New Jersey representative.

“If you continue the subsidies, there'll be $26 billion next year going to insurance companies,” he said, arguing that a fifth of that would go toward those companies’ profits, and the rest to patients.

“The president and I would rather give the 100 percent to the patient,” Cassidy said.

But he cautioned that if Trump said he supported Cassidy’s policy, Democrats would automatically be against it so they wouldn’t give the president a win.

Cassidy assailed the high deductible on the silver tier plan, which in 2026 will average $5,304, according to an analysis from the health policy research organization KFF. But that deductible could change significantly if an individual qualifies for a cost-sharing reduction payment, which lowers out-of-pocket costs for low-income enrollees. A cost-sharing reduction payment can bring a silver plan deductible down to as low as $80, depending on the income of the customer.

Cassidy, who was the deciding vote in confirming Robert F. Kennedy Jr. as health secretary, also addressed a decision last Friday by a vaccine advisory panel Kennedy hand-picked to no longer recommend that babies born to mothers who test negative for hepatitis B get a shot against it within 24 hours of birth.

He said that he saw people die of hepatitis B acquired at birth during his previous career as a liver doctor.

“And since we began doing the recommendation, not the mandate, for hepatitis B vaccination at birth — recommendation, not a mandate — the number of cases with hepatitis B has gone from 20,000 a year to 20 a year. What a remarkably successful intervention!” he said.

The Advisory Committee on Immunization Practices, which provides vaccine policy guidance to the Centers for Disease Prevention and Control, voted to end the blanket recommendation that all infants get vaccinated at birth against hepatitis B, maintaining that guidance only for infants whose mothers test positive for the infection or have unknown status.

Some ACIP committee members pointed to several European countries, such as Denmark, which don’t recommend a universal birth dose of the hepatitis B vaccine due to low transmission risk.

Cassidy called that “such a selective bias of presentation information,” arguing that the overwhelming majority of countries in the world do recommend the universal birth dose.

He refused to disclose what his next steps would be if ACIP continues to make significant changes to the U.S. vaccine schedule, but he did say that he plans to hold hearings with the CDC, the Food and Drug Administration and the National Institutes of Health.

Cassidy said his agreement with Kennedy in exchange for Cassidy voting for his confirmation was for the health secretary to come before the HELP committee quarterly. “And so we requested that he come back,” Cassidy said about Kennedy.