GOP, DEMOCRATS TALK ABOUT COM­PRO­MISE

Some sen­a­tors ready to “pivot to an­other strat­egy”

The Denver Post - - FRONT PAGE - By Tony Pugh and Les­ley Clark

Se­nate Ma­jor­ity Leader Mitch McCon­nell will move next week on a mea­sure to dis­man­tle the Af­ford­able Care Act, but, pre­dict­ing fail­ure, other sen­a­tors are al­ready talk­ing about ar­eas of com­pro­mise.

WASH­ING­TON» Se­nate Ma­jor­ity Leader Mitch McCon­nell will move next week on a mea­sure to dis­man­tle the Af­ford­able Care Act, but, pre­dict­ing fail­ure, other sen­a­tors are al­ready talk­ing about ar­eas of com­pro­mise be­tween Repub­li­cans and Democrats.

Sen. John Thune, R-S.D., chair­man of the Se­nate Repub­li­can Con­fer­ence, said there was a “good chance” that if Repub­li­cans prove un­suc­cess­ful next week there could be pres­sure to “pivot to an­other strat­egy, which could in­clude shorter term mea­sures where you are deal­ing with some of the Democrats, as­sum­ing they are in­ter­ested in help­ing.”

Sen. Ron John­son, R-WI, who chairs the Se­nate Com­mit­tee on Home­land Se­cu­rity and Gov­ern­men­tal Af­fairs, said he’s talked with the top Demo­crat on the com­mit­tee, Sen. Claire McCaskill, D-Mo., about hold­ing hear­ings on health care that would look more broadly at the en­tire sys­tem.

In a state­ment from Ari­zona, where he is re­cov­er­ing, Repub­li­can Sen. John McCain also en­dorsed the idea of hear­ings and ne­go­ti­a­tions with Democrats. “Congress must now re­turn to reg­u­lar or­der, hold hear­ings, re­ceive in­put from mem­bers of both par­ties, and heed the rec­om­men­da­tions of our na­tion’s gov­er­nors so that we can pro­duce a bill that fi­nally pro­vides Amer­i­cans with ac­cess to qual­ity and af­ford­able health care.”

Democrats sig­naled they were ready to talk too.

Sen. Tom Carper, D-Del., said he has talked sev­eral times with McCain and is “hope­ful” that af­ter the vote col­lapses Repub­li­cans will be­gin working with their Demo­cratic col­leagues. “If there are not the votes to move for­ward, then I think you will find plenty of Democrats and Repub­li­cans who will work to­gether,” he said.

In­deed, a com­pro­mise pack­age is not im­pos­si­ble, ar­gued Sab­rina Cor­lette, re­search pro­fes­sor at Ge­orge­town Uni­ver­sity’s Cen­ter on Health In­surance Re­forms.

“My some­what naive view would be that yes, ab­so­lutely, on pol­icy, they can come to bi­par­ti­san agree­ment. That’s the easy part. It’s the politics that are hard,” Cor­lette said.

An easy fix that both par­ties might sup­port is a rein­sur­ance pro­gram to help in­sur­ers with a large num­ber of sicker, high-cost plan mem­bers. GOP House and Se­nate re­peal leg­is­la­tion both con­tain rein­sur­ance pro­pos­als. A bill by Carper and Sen. Tim Kaine, D-Va., would also cre­ate a rein­sur­ance pro­gram.

Ti­mothy Jost, an emer­i­tus law pro­fes­sor at Wash­ing­ton and Lee Uni­ver­sity, said an ef­fort to step up fed­eral en­roll­ment out­reach ef­forts might also find bi­par­ti­san sup­port. But dis­putes over re­tain­ing the Med­i­caid ex­pan­sion and strength­en­ing fed­eral sub­si­dies to help pur­chase mar­ket­place cov­er­age might not be so easy.

“You want to start with small bore things that ev­ery­body can agree on and then go from there,” said Jost.

An­other fix that might gain bi­par­ti­san sup­port is per­ma­nent fed­eral fund­ing of cost-shar­ing sub­si­dies that help low-in­come mar­ket­place en­rollees with their out-of-pocket costs. The Trump ad­min­is­tra­tion has been re­im­burs­ing in­sur­ers for the sub­si­dies on a monthly ba­sis, but has not com­mit­ted to do­ing so in the fu­ture. The fund­ing un­cer­tainty is caus­ing Oba­macare in­sur­ers to seek higher pre­mi­ums in 2018.

That’s an is­sue leg­is­la­tors need to act on now, Jost said. “It’s not some­thing to hold hear­ings on and de­cide in fall. That needs to hap­pen be­fore (the Au­gust) re­cess, if pos­si­ble.”

Cor­lette said Democrats and Repub­li­cans might agree to re­peal some ACA taxes, like the so-called Cadil­lac tax on high-cost health plans and reg­u­la­tory or tax re­lief for in­sur­ers will­ing to go into ru­ral coun­ties with no mar­ket­place in­sur­ers. But it wouldn’t be easy. Sen. Chris Mur­phy, DConn., who sits on the Se­nate health com­mit­tee, said he’s skep­ti­cal of talk that Repub­li­cans will work with Democrats. Mur­phy said he’s had “de­tailed con­ver­sa­tions” about el­e­ments of com­pro­mise if the Repub­li­can plan fails, “but it’s up to Mitch McCon­nell to de­clare when the process has failed and I worry that this is a per­pet­ual process that fails and restarts, fails and restarts.”

And even if Se­nate Repub­li­cans reach a leg­isla­tive agree­ment with Democrats, there’s no guar­an­tee that the more par­ti­san House would buy in.

House Mi­nor­ity Leader Nancy Pelosi said she wrote to House Speaker Paul Ryan sug­gest­ing the two par­ties could start to ad­dress the cost-shar­ing re­duc­tion pay­ments. “We’re ready to work in a bi­par­ti­san way on this.”

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