Bad blood in GOP over healthcare

Trump wants re­peal ef­forts kept alive. Sen­a­tors worry about Oba­macare sub­si­dies.

Los Angeles Times - - THE NATION - By Laura King laura.king@la­times.com Twit­ter: @lau­rak­ingLAT Times staff writer Joseph Tan­fani in Wash­ing­ton con­trib­uted to this re­port.

WASH­ING­TON — A pair of prom­i­nent law­mak­ers urged Pres­i­dent Trump on Sun­day not to sab­o­tage the Af­ford­able Care Act, or Oba­macare, in the wake of failed Repub­li­can ef­forts to scrap his pre­de­ces­sor’s sig­na­ture leg­isla­tive achieve­ment.

But Trump urged GOP sen­a­tors to try again to push through some ver­sion of re­peal­ing and re­plac­ing the law, even though Se­nate Ma­jor­ity Leader Mitch McCon­nell (R-Ky.) said last week that it was time to move on to other mat­ters.

Trump se­nior ad­vi­sor Kellyanne Con­way said the pres­i­dent would de­cide in com­ing days whether to block sub­si­dies that are a cru­cial com­po­nent of the ex­ist­ing healthcare law.

“He’s go­ing to make that de­ci­sion this week, and that’s a de­ci­sion that only he can make,” Con­way said on “Fox News Sun­day.”

Two of the law­mak­ers who blocked the Se­nate Repub­li­can re­peal plan last week crit­i­cized the ad­min­is­tra­tion’s con­tin­ued ef­forts to over­turn the law.

Sen. Su­san Collins, the Maine Repub­li­can who stead­fastly re­jected a se­ries of GOP healthcare mea­sures last week, blamed the Trump ad­min­is­tra­tion for en­cour­ag­ing in­sta­bil­ity in the in­sur­ance mar­kets by con­tin­u­ing the un­cer­tainty over whether the sub­si­dies — cost-shar­ing pay­ments that re­duce out-of-pocket healthcare costs for poorer Amer­i­cans — would con­tinue.

“I’m trou­bled by the un­cer­tainty that has been cre­ated by the ad­min­is­tra­tion,” Collins said on NBC’s “Meet the Press.” She con­tested Trump’s char­ac­ter­i­za­tion of the pay­ments as an “in­sur­ance com­pany bailout.”

“That’s not what it is,” she said, calling the re­duc­tion pay­ments “vi­tal as­sis­tance” to low-in­come Amer­i­cans.

And Sen. Lisa Murkowski of Alaska said fur­ther ac­tion on healthcare should be done in a bi­par­ti­san man­ner and not rushed.

“You can­not do ma­jor en­ti­tle­ment re­form sin­gle-hand­edly, and you wouldn’t do ma­jor leg­isla­tive ini­tia­tives sin­gle-hand­edly,” she told re­porters in Alaska.

Sen. Bernie San­ders (IVt.) echoed Collins’ crit­i­cism of Trump’s threat to stop mak­ing the cost-shar­ing pay­ments.

“You know, I re­ally think it’s in­com­pre­hen­si­ble that we have a pres­i­dent of the United States who wants to sab­o­tage healthcare in Amer­ica, make life more dif­fi­cult for mil­lions of peo­ple who are strug­gling now to get the health in­sur­ance they need and to pay for that health in­sur­ance,” he said on CNN’s “State of the Union.”

Be­fore head­ing out for a day at his Vir­ginia golf prop­erty, Trump tweeted that Repub­li­can sen­a­tors should press ahead with ef­forts to scrap Oba­macare — a day af­ter he taunt­ingly ex­horted them not to be “quit­ters” in the quest for a leg­isla­tive vic­tory for him.

The White House bud­get di­rec­tor, Mick Mul­vaney, on “State of the Union,” said it was of­fi­cial Trump ad­min­is­tra­tion pol­icy that the Se­nate should keep work­ing to re­peal and re­place the Af­ford­able Care Act, es­chew­ing an Au­gust re­cess if nec­es­sary.

Sen­a­tors, he said, “need to stay, they need to work — they need to pass some­thing.”

Health and Hu­man Ser­vices Sec­re­tary Tom Price, while ac­knowl­edg­ing a re­spon­si­bil­ity to “fol­low the law,” also sig­naled that Trump was not ac­cept­ing de­feat in ef­forts to get rid of Oba­macare.

“Our goal ... as well as the pres­i­dent’s goal, is to put in place a law, a sys­tem, that ac­tu­ally works for pa­tients,” he said on “Meet the Press,” adding, “You can’t do that un­der the cur­rent struc­ture.”

Frus­trated by the fail­ure of the Oba­macare re­peal in the Se­nate, Trump on Sat­ur­day had threat­ened to end fed­eral sub­si­dies for healthcare in­sur­ance — for Congress as well as the rest of the coun­try.

“If a new HealthCare bill is not ap­proved quickly, BAILOUTS for In­sur­ance Com­pa­nies and BAILOUTS for Mem­bers of Congress will end very soon!” Trump tweeted, fum­ing about Congress’ fail­ure to re­peal the Af­ford­able Care Act, which he said was “im­plod­ing.”

Such a move could cause havoc and much higher pre­mi­ums in in­sur­ance mar­kets, since many low- and mod­er­ate-in­come peo­ple de­pend on those sub­si­dies to help cover the cost of their poli­cies. Through a se­ries of ad­min­is­tra­tive ma­neu­vers by Congress and the Obama ad­min­is­tra­tion, mem­bers and their staffs also ben­e­fit from those sub­si­dies.

Tar­get­ing con­gres­sional healthcare might score Trump some pop­ulist points with his base, but it would prob­a­bly come at a cost of poi­son­ing his re­la­tion­ship with Congress. Just mak­ing the threat high­lights how far things have eroded be­tween Trump and top Repub­li­can law­mak­ers. And it came a day af­ter Trump pushed out for­mer Chief of Staff Reince Priebus, an es­tab­lish­ment Repub­li­can who was the GOP con­gres­sional lead­er­ship’s trusted li­ai­son in the White House.

Trump’s long-stand­ing threat to let the health in­sur­ance plans fail would come with its own po­lit­i­cal price. The fed­eral gov­ern­ment sends about $600 mil­lion a month to in­sur­ance com­pa­nies to help cover the cost, and Trump is threat­en­ing to cut that off to al­low Oba­macare mar­kets to col­lapse.

His goal is to pres­sure Congress to send him a re­peal bill, but so far the strat­egy has failed. The con­fi­dence Trump has ex­pressed that if he fol­lowed through with the threat the fall­out would land not on him but on Democrats, be­cause they cre­ated Oba­macare, is not widely shared in Wash­ing­ton.

Mark Wil­son Getty Im­ages

SEN. LISA MURKOWSKI (R-Alaska) said healthcare ne­go­ti­a­tions should be bi­par­ti­san and not rushed.

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