Collins urges President Trump to back effort to restore health subsidy

WASHINGTON» A key moderate Republican urged President Donald Trump on Sunday to back a bipartisan Senate effort to shield consumers from rising premiums after his abrupt decision to halt federal payments to insurers, calling the move “disruptive” and an immediate threat to access to health care.

“What the president is doing is affecting people’s access and the cost of health care right now,” said Sen. Susan Collins of Maine, who has cast pivotal votes on health care in the narrowly divided Senate. “This is not a bailout of the insurers. What this money is used for is to help low-income people afford their deductibles and their copays.”

“Congress needs to step in, and I hope that the president will take a look at what we’re doing,” she added.

Her comments reflected an increasing focus Sunday on the bipartisan Senate effort led by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., to at least temporarily reinstate the payments to avoid immediate turmoil in the insurance market, even as Trump signaled he wouldn’t back a deal without getting something he wants in return.

The payments will be stopped beginning this week, with sign-up season for subsidized private insurance set to start Nov. 1.

“The president is not going to continue to throw good money after bad, give $7 billion to insurance companies unless something changes about Obamacare that would justify it,” said Sen. Lindsey Graham, R-S.C.

“It’s got to be a good deal,” Graham said.

In his decision last week, Trump derided the $7 billion in subsidies as bailouts to insurers and suggested he was trying to get Democrats to negotiate and agree to a broader effort to repeal and replace former President Barack Obama’s health care law, a bid that repeatedly crashed in the GOPrun Senate this summer.

The payments seek to lower out-of-pocket costs for insurers, which are required under Obama’s law to reduce poorer people’s expenses — about 6 million people. To recoup the lost money, carriers are likely to raise 2018 premiums for people buying their own health insurance policies.

Alexander and Murray have been seeking a deal that the Tennessee Republican has said would reinstate the payments for two years. In exchange, Alexander said, Republicans want “meaningful flexibility for states” to offer lower-cost insurance policies with less coverage than Obama’s law mandates.

Still, congressional Republicans are divided over that effort. White House budget director Mick Mulvaney has suggested that Trump may oppose any agreement unless he gets something he wants — such as a repeal of Obamacare or funding of Trump’s promised wall on the U.S.-Mexico border.

On Sunday, House Minority Leader Nancy Pelosi, D-Calif., described Trump’s demand for a sitdown with congressional Democratic leaders as “a little far down the road.” She noted the bipartisan effort in the Senate and said ultimately it will be up to a Republican-controlled Congress and executive branch whether the federal government can avert a shutdown by year’s end.

The government faces a Dec. 8 deadline on the debt limit and government spending.

“We’re not about closing down government. The Republicans have the majority,” Pelosi said. “In terms of the health care, we’re saying ‘Let’s follow what Sen. Murray and Alexander are doing.’ ”

Collins praised the Senate effort so far, which included public hearings by the Senate health and education committee. Still, she acknowledged a potentially tough road in reaching broader agreement.

“I hope we can proceed, but Democrats will have to step up to the plate and assist us,” said Collins, who is a member of the committee. “It’s a two-way street.”

The scrapping of subsidies would affect millions more consumers in states won by Trump last year, including Florida, Alabama and Mississippi, than in states won by Democrat Hillary Clinton. Nearly 70 percent of the 6 million who benefit from the costsharing subsidies are in states that voted for Trump.

Republican Gov. John Kasich of Ohio called for the payments to be reinstated. “Over time, this is going to have a dramatic impact,” Kasich said. “Who gets hurt? People. And it’s just outrageous.”