Will deal with Democrats on health care, Trump says

WASHINGTON — A day after the latest GOP plan to repeal the Patient Protection and Affordable Care Act failed in the Senate, President Donald Trump said he will negotiate with Democrats on health care and “see if I can get a health plan that is even better.”

Trump, speaking to reporters outside the White House on Wednesday, also asserted that Republicans have the votes to push health care legislation through the Senate but they’ve been flummoxed because one supportive senator is in the hospital.

Yet Senate GOP leaders a day earlier scrapped their drive to repeal President Barack Obama’s health care overhaul because they lacked the votes to succeed. Because of their narrow majority and unified Democratic opposition, Republicans could lose just two GOP votes and still push the legislation through the Senate.

The three GOP senators whose opposition sank the Republican measure all remained against it, aides confirmed. They are Arizona’s John McCain, Kentucky’s Rand Paul and Maine’s Susan Collins.

But on Wednesday, Trump said, “We have the votes for health care. We have one senator that’s in the hospital. He can’t vote because he’s in the hospital.”

White House aides later said the hospitalized lawmaker Trump was talking about was Sen. Thad Cochran, R-Miss., who turns 80 in December.

“Thanks for the well-wishes,” Cochran tweeted. “I’m not hospitalized, but am recuperating at home in Mississippi and look forward to returning to work soon.”

Cochran’s aides said he was being treated for a urological problem and could return to Washington if a vote was planned.

Trump later said the senator was “home recovering.”

Sen. Lisa Murkowski, R-Alaska, had also expressed that she was leaning against the bill. She never formally took a position on the bill, calling the hasty process in which it was drafted “lousy” and declaring that “substance matters.”

On Twitter, Trump cited “very positive signs” from Murkowski and “two others.” He added, “we have the HCare Vote, but not for Friday!”

Senators needed to vote on the measure this week because procedural protections against a Democratic filibuster expire Sunday, though they could revisit the issue in future months.

In an effort to follow through on another campaign promise, Trump said Wednesday that he was considering signing a “major executive order” that would allow people to purchase health insurance across state lines.

“It’s being finished now. It’s going to cover a lot of territory and a lot of people, millions of people,” Trump told reporters.

Paul has been pushing Trump to make good on his promise and said he can do so by expanding “association health plans” that would allow individuals to pool together and buy insurance outside their states.

“Conservatives are still fighting for free-market reforms to the health care system,” Paul said in a statement. “I am excited to be working with President Trump on this initiative.”

‘A BIG IF’

By Wednesday, no top Republicans were talking about returning to the health care matter until they get the 50

votes they’d need to succeed, a tie Vice President Mike Pence would break.

South Dakota Sen. John Thune, the chamber’s No. 3 GOP leader, said that if the bill’s sponsors “get to where they can get 50 votes or something, my guess is we’ll be coming back to it. That’s a big if.”

“That’s probably a question for a little bit down the road,” said Sen. Bill Cassidy, R-La., a sponsor of the last failed bill, when asked when the push would be revisited. “We have to reassess and regroup.”

The withdrawn bill, which Cassidy sponsored with Sen. Lindsey Graham, R-S.C., would collapse much of Obama’s law into block grants states would receive to shape their own programs.

Trump offered two pathways to success.

First, he said Republicans would have the votes to succeed early next year. But with the procedural rules expiring Sunday, Republicans controlling the Senate 52-48 will no longer be able to win with just 50 votes. They’d need 60 votes, an impossibility thanks to unbroken Democratic opposition to repealing one of the party’s proudest achievements.

“They could try it again and again because they’re going to fail again and again,” Senate Minority Leader Charles Schumer, D-N.Y., said in a brief interview.

Congress could vote to renew the health care bill’s 50-vote protection next year. But GOP leaders are talking about first using that protection for their current top priority, tax cuts, not health care. And it’s unclear that Republicans are eager to revisit the issue in an election year.

As a second option, Trump said he’d talk to Democrats “and I will see if I can get a health care plan that is even better.”

The No. 2 Senate Democratic leader, Richard Durbin of Illinois, said the White House has yet to approach Democrats

with a health care compromise and said he didn’t see what one might look like.

“Block grants to the states with inadequate funding?” Durbin said of the abandoned bill. “Cutbacks in Medicaid? Reductions in health insurance? Those are not good starting points for a bipartisan discussion.”

Neither Trump, House Speaker Paul Ryan nor Senate Majority Leader Mitch McConnell has given clear approval for a bipartisan approach. Some governors have called for a health care reset that would involve both parties working together on a limited agenda, but their suggestion hasn’t been embraced in Washington.

“The question is whether you can forge a coalition that doesn’t include either the hard right or the hard left,” said GOP health economist Gail Wilensky. “I have not been able to answer who would provide the leadership for such an effort. Neither the leadership in the House or the Senate has embraced the notion of trying to forge a bipartisan coalition, and it is very hard to move legislation without that.”

COST-SHARING DOUBTS

Meanwhile, confusion sowed by Trump’s opposition to the 2010 health law roiled the health insurance market Wednesday, when in many states a deadline lapsed for insurers to lock in their rates for next year.

Some insurers announced double-digit increases. Florida said Tuesday that most of its 45 percent average increase in premiums stems from the risk that the Trump administration will skip cost-sharing payments that reimburse insurers for lowering rates. California said premiums may jump by almost 25 percent on average.

Trump, who has repeatedly called the Affordable Care Act a failure, has fostered doubt over how the federal government will run the individual markets under the law. The administration has cut funding for outreach and signaled that it may weaken enforcement of the law’s requirement that all people have coverage or pay a fine, raising the risk that only sicker people will buy plans. Pronouncements from top administration officials that the law is collapsing are feared to discourage enrollment.

“How many people are out there, who don’t pay as obsessive attention to this stuff as we do, might already think the law has been repealed?” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “At the same time that you have the funding for advertising and marketing and messaging being cut, you have an increased need for it.”

About 83 percent of the 12.2 million people who picked Affordable Care Act plans for this year got subsidies to help them afford coverage. The subsidies, based on the cost of a health insurance plan, can help insulate people from climbing premiums. Despite its opposition to the cost-sharing payments, the Trump administration has continued to pay them.

Trump could be a “hero” if he paid the subsidies for next year but demanded companies lower their rates, “because most companies have raised rates because of the uncertainty,” said Kathleen Sebelius, who led the Department of Health and Human Services in the Obama administration.

“You could actually have rates drop across the country before open enrollment dramatically and claim victory,” she said.