Here's the draft text of the deal struck by Sens. Lamar Alexander and Patty Murray, obtained from a senior GOP aide. The plan can now be seriously evaluated, especially regarding changes made to Affordable Care Act state innovation waivers.
Items of note:
Revised waiver language requires states to "provide coverage and cost sharing protections against excessive out-of-pocket spending that are of comparable affordability, including for low-income people, people with serious health needs, and other vulnerable populations."
State insurance regulators must submit a certification to the Department of Health and Human Services that the state will make sure plans receiving cost sharing reduction subsidies in 2018 pass those benefits on to enrollees or the federal government, and a plan for doing so. This is intended to prevent insurers that charged higher premiums in 2018 in anticipation of not receiving the payments don't just keep the payments once they're appropriated.
Requires HHS to release guidance on model state plans that meet waiver approval requirements. This could include, for example, a state plan to create a reinsurance program or invisible high risk pool.