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McSally Floats 'Bipartisan' Fixes To ACA Marketplace

Arizona Congresswoman Martha McSally is drumming up support for a bipartisan plan aimed at improving the Affordable Care Act's individual marketplace.

While there's no legislation yet, McSally and about 40 other House lawmakers, calling themselves the Problem Solvers Caucus, have been hammering out a handful of "narrow, targeted initiatives" to shore up the marketplace in the event the Senate did not succeed in replacing the law.

"Can we break through, look at this menu of items and agree on moving some of them forward," McSally told KJZZ on Monday, "instead of trying to solve the whole thing together and then nothing happens while we watch the individual marketplace collapse."

Among the ideas, McSally would like to give Congress the authority over the cost sharing reduction payments, which help low-income people buy coverage. President Donald Trump has threatened withholding those subsidies, which insurance companies warn would further destabilize the market.

McSally said they have been working on this issue for several weeks — before Trump's most recent threat to withhold the next round of payments.

Other ideas floated by the Problem Solvers Caucus:

Eliminate the medical device tax; let businesses hire more people without having to offer insurance; set aside funding to help states shore up the marketplace, especially to cover those with pre-existing conditions.

McSally said the "stability fund" would "take that slice of the individual market pie and provide resources to the states to backstop those costs and provide better care and support, but not have them [those with pre-existing conditions] driving up everyone else's premiums."

She said that could take the form of a risk-pool or some other mechanism. McSally also contends that raising the threshold for the employer mandate from 50 to 500 employees will encourage small business growth, while "allowing individuals to go into the individual market."

Critics of the Republican replacements for the ACA like Dana Wolfe Naimark, head of the Children's Action Alliance, are encouraged.

"This package is much more productive and worth exploring than many of the proposals we have seen over the last few months that seemed to throw a lot of things into the mix that were very harmful."

Arizona's marketplace has struggled with only a few options and high premiums. Still, Naimark believes it is stabilizing and could benefit from changes that help consumers afford coverage.

McSally's proposal would be paid for mostly by changes to Medicare, although the details aren't clear yet.

"We need to think very carefully about what impact those will have and who they will affect," Naimark said, "But overall we are thrilled to see a bipartisan, concrete proposal that is focused on results and open to constituent input and hearings."

Will Stone grew up with the sounds of public radio. As a senior field correspondent, he strives to tell the same kind of powerful stories that got him into the business — whether that means trudging through some distant corner of the Sonoran Desert or uncovering an unknown injustice right down the street. Since joining the KJZZ newsroom in 2015, he has covered political scandals, fights over the future of energy, and efforts to care for some of Arizona’s most vulnerable communities. His pieces have also aired on national programs like Morning Edition, All Things Considered, Here & Now and Marketplace. Before coming to KJZZ, he reported for public radio stations in Nevada and Connecticut. Stone received his degree in English literature from Haverford College, where he also wrote about the arts and culture scene in Philadelphia. After graduating, he interned at NPR West in Culver City, California, where he learned from some of the network’s veteran reporters and editors. When he doesn’t have a mic in hand, Stone enjoys climbing mountains, running through his central Phoenix neighborhood and shamelessly promoting his cat, Barry.