Threat: End health payments unless there’s an overhaul

President tweets after vote to repeal ACA fails Friday.

WASHINGTON — President Donald Trump on Saturday threatened once more to end the Affordable Care Act’s payments to insurance companies, and subsidies for Congress’ own health insurance, unless lawmakers repeal and replace the Obama-era health care law.

In apparent frustration over Friday’s failure by the Senate Republican majority to pass a bill repealing parts of the law, Trump tweeted: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” He also tweeted that the failed vote made lawmakers look “like fools.”

Repeal-and-replace has been a guiding star for Republicans ever since then-President Barack Obama signed the law in 2010. The issue has dominated the opening months of Trump’s presidency, but Senate Majority Leader Mitch McConnell said after the bill failed early Friday that he would move to other legislative business in the upcoming week.

Trump, however, refused on Saturday to accept the defeat.

“Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!” he tweeted.

The insurance company subsidies, totaling about $7 billion a year, help reduce deductibles and copayments for consumers with modest incomes.

The Obama administration used its rule-making authority to set direct payments to insurers to help offset those costs. Trump inherited the payment structure, but he also has the power to end them.

The payments are the subject of a lawsuit brought by House Republicans over whether the Affordable Care Act specifically included a congressional appropriation for the money, as required under the Constitution. Trump has only guaranteed the payments through July, which ends Monday.

Trump previously said the law that he and others call “Obamacare” would collapse immediately whenever those payments stop. He has indicated a desire to halt the subsidies but so far has allowed them to continue on a month-to-month basis.

Without the payments, analysts have said, more insurers might drop out of the system, limiting options for consumers and clearing the way for the insurers who stay to charge more for coverage.

The Democratic leader in the Senate, Chuck Schumer of New York, cautioned against such a step, saying it would make health care more expensive. None of the Senate’s Democrats voted for the repeal bill, but Schumer has offered to negotiate on fixes to the health law.

“If the president refuses to make the cost sharing reduction payments, every expert agrees that premiums will go up and health care will be more expensive for millions of Americans,” Schumer said Saturday in a written statement. “The president ought to stop playing politics with people’s lives and health care, start leading and finally begin acting presidential.”

Antonia Ferrier, a spokeswoman for McConnell, declined to comment on Trump’s posts. But McConnell’s former chief of staff, Josh Holmes, cited Trump’s tweets Saturday as he sardonically suggested a “search for the idiot who keeps putting the president on irrelevant and counterproductive crusades.”

Trump also in his Twitter comments criticized the Senate’s filibuster rules, under which he predicted “many great Republican bills will never pass,” including health care legislation. The rule in most cases requires a 60-vote supermajority of the 100-member Senate to end debate on a bill before it can come to the floor for a simple up-or-down vote. The Republicans have 52 votes — not enough to prevail when Democrats refuse to go along. “Republican Senate must get rid of 60 vote NOW! It is killing the R Party, allows 8 Dems to control country. 200 Bills sit in Senate. A JOKE!” Trump wrote.