Sen. Lamar Alexander says if lawmakers can't do that, "the blame will be on every one of us, and rightfully so".
"If Washington state gets something approved, why can't Tennessee come along and say, 'We want to do what Washington state did with one change?'" the chairman said.
Three Republicans and two Democrats told the Senate Health Committee to demand at least a year's worth of federal cost-sharing money that reimburses plans for paying low-income customers' costs, saying Mr. Trump's attempt to use the money as leverage in his zeal for repeal is forcing insurers to boost premiums and head for the exits.
President Donald Trump threatened to eliminate those payments in the wake of Senate Republicans' failure to approve a bill to repeal and/or replace the Affordable Care Act in July.
Uncertainty has already caused some insurers to flee the market, but all five agreed that Congress could reduce some of the anxiety, and head off sharp premium hikes next year, if it funds cost-sharing reduction payments through 2018 - if not beyond - as well as reinsurance programs.
"Threading this needle won't be easy", Murray said. And it must protect patients from extreme out-of-pocket costs.
Senators' remarks underscored the differences lawmakers must overcome.
McPeak said she believed a reinsurance program or a high-risk pool could remove the highest cost claims and help insurers bring prices down. Michael Bennet, D-Colo., warned against easing coverage requirements, saying it was crucial that consumers not be forced to buy "lousy insurance".
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Massachusetts Gov. Charlie Baker (R) said that insurers selling ACA coverage there - a lot of them nonprofit - have set premium rates for the coming year based on the assumption that the subsidies will continue.
Here, too, Miller pointed at actions the Trump administration has taken to undermine the ACA, including shortening the enrollment period and reducing funding for advertising and enrollment assistance. Instead, both parties should dedicate themselves to building on it - and, to that end, work is needed by the end of this month, when insurers are due to sign contracts to sell policies on the state exchanges next year. Political opposition from Republicans complicated matters by gumming up the law's internal financial stabilizers for insurers.
Noting the upcoming deadline for insurers to file their 2018 individual exchange rates with the Department of Health and Human Services - part of the decision whether to participate in the individual markets next year - Sen. Just last week, eight governors led by Hickenlooper and John Kasich, R-Ohio, proposed a plan that would guarantee the cost-sharing subsidies while also giving states more flexibility in how they implement the 2010 health-care law. Nearly 7 million lower-earning people benefit from the reductions.
But will Congress take the plan seriously and approve it?
He and other lawmakers are on a clock: insurance companies have until September 27 to decide whether it makes sense for them to participate in the ACA exchanges.
About 18 percent of New Yorkers get their health insurance through the state program, and consumers need to re-apply yearly to get insurance from one of the more than a dozen insurers who offer plans.
"What we really need to grapple with - and all these governors have talked about it - is we're spending twice as much as what any other industrialized country in the world is spending on health care and we're getting worse results - increasingly worse results - and that's not satisfactory to people in Colorado whether they support the affordable care act or whether they don't".