Austin American-Statesman

Trump backs away from bipartisan ACA proposal

- By Sean Sullivan and Juliet Eilperin Washington Post

President Donald Trump appeared to distance himself further from a bipartisan Senate health-care effort Wednesday, warning against “bailing out” insurance companies.

“I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co’s who have made a fortune w/ O’Care,” Trump wrote on Twitter. He was referring to Sen. Lamar Alexander, R-Tenn., who forged a deal with Sen. Patty Murray, D-Wash., that was released Tuesday and was greeted by ample GOP skepticism.

The president’s tweet Wednesday was his latest conflictin­g statement about the Alexander-Murray plan.

The compromise would authorize payments to health insurers that help millions of lower-income Americans afford coverage in exchange for granting states greater flexibilit­y to regulate health coverage under the Affordable Care Act.

Trump ended the payments, known as CSRs, last week, arguing that they were illegal because they were not explicitly authorized under the ACA. He left it to Congress to decide whether to fund them.

Initially, on Tuesday, Trump said the Alexander-Murray proposal would “get us over this intermedia­te hump” and allow Republican­s to later revisit efforts to aggressive­ly undo the ACA. But later Tuesday, he was noticeably cooler to the idea, saying, “I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies.”

Alexander, who has repeatedly emphasized that he had been empowered by the president to forge the agreement, said in an interview that Trump did not close the door to the deal in a phone call Wednesday morning.

“He told me that he wanted to encourage me but that he will review it, as I would expect a president to do,” the senator said. “He may want to add something to it. It may come up as part of the end-of-the-year negotiatio­ns. We’ll see.”

Although Trump has repeatedly described cost-sharing payments as a “bailout” to insurers, the money directly covers the discounts that low-income Americans covered under the Affordable Care Act receive for deductible­s and other out-of-pocket costs. This group includes about 7 million Americans earning up to 250 percent of the federal poverty level.

Insurers are obligated to provide the discounts, which totaled about $7 billion this year and are estimated to reach $10 billion next year, even if the federal payments are cut off. According to the National Associatio­n of Insurance Commission­ers, Trump’s decision last week to end the subsidies will cost insurance carriers more than $1 billion this year.

Facing the prospect for months that the Trump administra­tion would cut off the payments, most insurers have opted to factor this shortfall into their 2018 premium rates for all their customers. The cutoff in cost-sharing payments has translated into premium increases of 12 percent to 20 percent, according to several analyses.

Speaking to reporters in the Cabinet Room on Wednesday, Trump praised Alexander’s efforts, saying, “If something can happen, that’s fine, but I won’t do anything to enrich the insurance companies.”

“They’ve been enriched by Obamacare like nothing anybody’s ever seen before,” the president added.

Trump’s increasing skepticism puts him in line with congressio­nal Republican­s, many of whom are not championin­g the plan. Senate Majority Leader Mitch McConnell, Ky., did not mention it in a speech opening Senate business Wednesday morning. On Tuesday, McConnell said he hadn’t “had a chance to think about the way forward yet.”

Key House Republican­s have been outright hostile.

“None of our guys voted for Obamacare,” Rep. Tom Cole, Okla., a close ally of House GOP leaders, said in an interview Tuesday. “They’re not very interested in sustaining it.”

But Democratic leaders have been supportive of the blueprint. Speaking on the Senate floor Wednesday, Minority Leader Charles Schumer of N.Y., who discussed the prospect of a bipartisan deal with Trump less than two weeks ago, railed against the him for his about-face.

“The president doesn’t know what he’s talking about,” Schumer said of Trump’s suggestion that legislatio­n authorizin­g the subsidies amounted to an industry bailout.

 ?? J. SCOTT APPLEWHITE / ASSOCIATED PRESS ?? Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander, R-Tenn., seen Wednesday at the Senate Health Committee, have crafted a bipartisan proposal for ACA cost-sharing payments.
J. SCOTT APPLEWHITE / ASSOCIATED PRESS Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander, R-Tenn., seen Wednesday at the Senate Health Committee, have crafted a bipartisan proposal for ACA cost-sharing payments.
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