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Rounds Statement on Alexander/Murray Legislation

Is one of 24 Senators – 12 Republican and 12 Democrat – to Cosponsor Bipartisan Bill; Similar Provision had Support from 49 of 52 GOP Senators

WASHINGTON— Following months of discussions between U.S. Sens. Mike Rounds (R-S.D.), Lamar Alexander (R-Tenn.), Patty Murray (D-Wash.) and Angus King (I-Maine), Rounds made the following statement on the bipartisan Alexander/Murray legislation, which will give states additional flexibility to tailor their health insurance market to fit their individual needs. It also temporarily authorizes Cost Sharing Reduction (CSR) payments, which will protect consumers from even higher premiums and help stabilize the market in the near-term.


“Obamacare is a rapidly sinking ship,” said Rounds. “Our agreement will give us time to stabilize the market and provide meaningful flexibility and relief to states while we continue our efforts to repeal and replace Obamacare with a competitive, market-based health care system that is actually affordable. In the meantime, we protect low-income families from even higher premiums by temporarily continuing the CSR payments for two years. Meanwhile, we are making meaningful, permanent reforms to the 1332 waiver process, which will provide much-needed relief to states and allow them to tailor their health insurance markets to fit their individual needs. Empowering the states with new opportunities to innovate and strengthen their health insurance market is a significant step in the right direction.”


CSR payments are essentially a government subsidy for low-income individuals. Last week, President Trump announced the administration would stop making the monthly CSR payments, citing a May 2016 federal court ruling which found the payments were unconstitutional because Congress had not appropriated money for this purpose. 


This legislation would provide permanent, significant reforms to Obamacare’s ‘1332 waivers.’ Due to House and Senate rules, the 1332 waiver changes outlined in the Alexander/Murray legislation are not eligible to be included in “budget reconciliation” legislation, which is the vehicle being used to repeal and replace Obamacare by congressional Republicans. Those efforts will continue. Alexander/Murray also modifies the affordability guardrails in a way that maintains patient protections but allows states to innovate and develop cheaper ways to cover more Americans.


It would also legally authorize the administration to temporarily continue CSR payments for two years, similar to the provisions of the Better Care Reconciliation Act, in which 49 GOP members of the U.S. Senate supported earlier this year.


Reforms to the 1332 Waiver Process Would:

  • Amend the law to provide meaningful flexibility for health plan designs;
  • Streamline the waiver approval process by letting governors apply for waivers without requiring state legislatures to pass an authorization law;
  • Allow for automatic approval of waivers if a state’s application is substantially similar to one already approved by federal authorities;
  • Cut the approval time at Health and Human Services (HHS) in half;
  • Provide additional fast-tracking opportunities for waivers in emergency circumstances; and
  • Allow for waivers to last longer than under current law (six years v. five years today).

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