Oba­macare talk now fo­cuses on a ‘fix’

Trump ad­min­is­tra­tion sig­nals an open­ness to a bi­par­ti­san ap­proach to the health­care law.

Los Angeles Times - - THE NATION - By Noah Bierman noah.bierman@la­times.com

BRIDGE­WA­TER, N.J. — The Trump ad­min­is­tra­tion, thwarted in sev­eral at­tempts to re­peal the Af­ford­able Care Act, no­tably shifted tone Wed­nes­day, open­ing the door for a bi­par­ti­san plan to “fix” the law.

The change came even as a fight es­ca­lated be­tween Pres­i­dent Trump and Se­nate Ma­jor­ity Leader Mitch McCon­nell (R-Ky.) over who is to blame for the Repub­li­can Party’s fail­ure to re­peal Oba­macare.

“Both folks in the House and the Se­nate, on both sides of the aisle, frankly, have said that Oba­macare doesn’t work, and it needs to be either re­pealed or fixed,” Health and Hu­man Ser­vices Sec­re­tary Tom Price said on the Fox News pro­gram “Fox & Friends.” “So the onus is on Congress.”

Talk of fix­ing the law is new for most Repub­li­cans. Price and Trump have long fo­cused only on re­peal­ing and re­plac­ing it.

The Repub­li­can-con­trolled Congress, de­spite seven years of cam­paign prom­ises, has been un­able to come up with a re­place­ment plan that can pass both cham­bers. And Democrats, who see the law as a sig­na­ture ac­com­plish­ment for Pres­i­dent Obama and their party, have been un­will­ing to par­tic­i­pate in a re­peal ef­fort.

Both sides agree changes are needed to sta­bi­lize in­sur­ance mar­kets. Large in­sur­ers have pulled out of sev­eral mar­kets, leav­ing some con­sumers with few or no plans from which to choose.

White House Press Sec­re­tary Sarah Huck­abee San­ders did not back away from Price’s word­ing when asked whether the ad­min­is­tra­tion is se­ri­ous about a plan to fix the law, rather than re­peal it.

“We are al­ways look­ing for best ways to im­prove and fix the bro­ken Oba­macare sys­tem,” she said in an email.

A spokes­woman for Price, Alleigh Marre, said Price, in his in­ter­view, “was char­ac­ter­iz­ing the po­si­tion of folks in Congress from both sides of the aisle who rec­og­nize Oba­macare is fail­ing.” She did not pro­vide de­tails of which fixes Price would find ac­cept­able.

The shift comes soon af­ter law­mak­ers in­ten­si­fied their own bi­par­ti­san ef­forts. Last week, Se­nate Health Com­mit­tee Chair­man La­mar Alexan­der (R-Tenn.) and Sen. Patty Mur­ray (DWash.), the com­mit­tee’s se­nior Demo­crat, an­nounced plans to be­gin work­ing on leg­is­la­tion to sta­bi­lize the mar­kets.

In­dus­try of­fi­cials have said a fix could in­clude at least four com­po­nents:

Pledg­ing to con­tinue gov­ern­ment as­sis­tance that the law of­fers to low- and mid­dle-in­come con­sumers to help off­set co­pay­ments and de­ductibles.

Cre­at­ing a bet­ter rein­sur­ance sys­tem to pro­tect in­sur­ers from big losses in the event they get an un­ex­pected glut of un­healthy and ex­pen­sive pa­tients.

In­creas­ing out­reach and mar­ket­ing to per­suade younger and health­ier peo­ple to buy in­sur­ance, thereby bal­anc­ing out ex­pen­sive claims from older and less healthy cus­tomers.

Cre­at­ing new plans or in­cen­tives to lure more in­sur­ers to sell plans in ru­ral ar­eas.

Even as talk of bi­par­ti­san­ship in­creases, Repub­li­cans re­main con­cerned about po­lit­i­cal fall­out from their core vot­ers, many of whom may be an­gered by the fail­ure to re­peal the ex­ist­ing law.

Ten­sion over that prob­lem prompted the re­cent in­fight­ing be­tween McCon­nell and the ad­min­is­tra­tion.

McCon­nell told an au­di­ence in his home state Mon­day that Trump had raised ex­pec­ta­tions un­re­al­is­ti­cally, in large part be­cause of his in­ex­pe­ri­ence with leg­is­lat­ing.

“Our new pres­i­dent has, of course, not been in this line of work be­fore,” McCon­nell said at a Ro­tary Club gath­er­ing in Florence, Ky. “And I think he had ex­ces­sive ex­pec­ta­tions about how quickly things hap­pen in the demo­cratic process.”

That elicited a re­sponse from Trump, who used his Twit­ter ac­count dur­ing his 17-day stay at his New Jersey golf course to fire back.

“Sen­a­tor Mitch McCon­nell said I had ‘ex­ces­sive ex­pec­ta­tions,’ but I don’t think so,” he wrote. “Af­ter 7 years of hear­ing Re­peal & Re­place, why not done?”

The pub­lic na­ture of the in­tra­party fight is un­usual. Though re­la­tions be­tween pres­i­dents and con­gres­sional lead­ers from the same party may of­ten be tense, con­flicts sel­dom break out into the open.

But Trump has been in­creas­ingly frustrated with what he sees as a lack of sup­port from Repub­li­cans in Congress, while law­mak­ers have grown more con­cerned that Trump’s low stand­ing in the polls and lack of leg­isla­tive ac­com­plish­ments could hurt them po­lit­i­cally.

Evan Vucci As­so­ci­ated Press

TOM PRICE, the sec­re­tary of Health and Hu­man Ser­vices, has pulled back from his hard-line push for re­peal­ing the Af­ford­able Care Act.

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