Short-term bipartisan health deal stalls
Blueprint panned amid mixed signals
WASHINGTON — Yet another last-ditch effort to tackle the nation’s health care system stalled within hours of its release by a bipartisan pair of senators Tuesday, with President Donald Trump sending mixed signals and Republicans either declining to endorse the proposal or outright opposing it.
The week began on Capitol Hill with a renewed sense of urgency to craft legislation following Trump’s decision last week to end key payments to health insurers that help millions of lower-income Americans afford coverage, but that the president argued were illegal under the Affordable Care Act.
The compromise offered by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on Tuesday proposes authorizing those payments for two years in exchange for granting states greater flexibility to regulate health coverage under the ACA. Those payments help offset deductibles and other out-of-pocket costs for low-income consumers who obtain insurance through the law; critics of Trump’s decision said eliminating the subsidies would cause insurers to back out of marketplaces across the country.
Senate Republican leaders did not immediately endorse the proposal. Influential House Republicans panned the blueprint and Trump offered conflicting reviews. The discord swiftly cast the plan’s viability into serious doubt.
In an address at a Heritage Foundation dinner in Washington on Tuesday, Trump suggested that a different kind of fix is needed.
“I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies,” Trump said.
Trump stopped the CSR payments last week, arguing the subsidies were illegal because they were not explicitly authorized under the ACA, and he instructed Congress to decide whether to appropriate the funding.
“None of our guys voted for Obamacare,” Rep. Tom Cole, R-Okla., a close ally of House GOP leadership, said in an interview. “They’re not very interested in sustaining it.”
A leading House conservative was outright hostile to the new bipartisan plan. “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable,” said Rep. Mark Walker, R-N.C., on Twitter. Walker is the chairman of the influential Republican Study Committee.
Senate Republican leaders were less than enthusiastic.
“We haven’t had a chance to think about the way forward yet,” said Senate Majority Leader Mitch McConnell, R-Ky., at his weekly news conference, minutes after Alexander announced the deal about 20 feet away outside a Republican policy luncheon.
Alexander said the deal he struck with Murray would extend CSR payments for two years and provide states “meaningful flexibility” under the ACA, allowing them to make changes to insurance offerings as long as the plans had “comparable affordability,” which is a slightly looser definition than the existing one.
In an interview, Senate Minority Leader Charles Schumer, D-N.Y., said both parties made concessions to produce a deal that would “stabilize the Affordable Care Act and undo a good amount of the sabotage that we’ve seen in recent days.”
“Each side had to give some, but that’s what this is all about,” Schumer added.
The framework would also allow insurers to offer catastrophic insurance plans to consumers 30 and older on ACA exchanges, while maintaining a single risk pool.