{"id":48004,"date":"2017-10-18T05:07:13","date_gmt":"2017-10-18T05:07:13","guid":{"rendered":"https:\/\/www.biphoo.com\/bipnews\/?p=48004"},"modified":"2017-10-18T05:07:13","modified_gmt":"2017-10-18T05:07:13","slug":"another-last-ditch-effort-to-tackle-obamacare-stalls-within-hours-of-its-release","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/news\/another-last-ditch-effort-to-tackle-obamacare-stalls-within-hours-of-its-release.html","title":{"rendered":"Another last-ditch effort to tackle Obamacare stalls within hours of its release"},"content":{"rendered":"

Another last-ditch effort to tackle Obamacare stalls within hours of its release<\/span><\/strong><\/span><\/h2>\n

Yet another last-ditch effort to tackle the nation\u2019s health-care system stalled within hours of its release by a bipartisan pair of senators Tuesday, with President Trump sending mixed signals and Republicans either declining to endorse the proposal or outright opposing it.<\/span><\/p>\n

The week began on Capitol Hill with a renewed sense of urgency to craft legislation following Trump\u2019s decision last week to end key payments to health insurers that help millions of lower-income Americans afford coverage but that the president argued were illegal under the Affordable Care Act.<\/span><\/p>\n

The compromise offered by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) on Tuesday proposes authorizing those payments for two years in exchange for granting states greater flexibility to regulate health coverage under the ACA. Those payments help offset deductibles and other out-of-pocket costs for low-income consumers who obtain insurance through the law; critics of Trump\u2019s decision said eliminating the subsidies would cause insurers to back out of marketplaces across the country.<\/span><\/p>\n

The measure presented congressional Republicans with an uncomfortable choice between helping sustain coverage for many Americans and making good on a long-standing campaign promise \u2014 and paying the consequences \u2014 by allowing the ACA to falter.<\/span><\/p>\n

Senate Republican leaders did not immediately endorse the proposal. Influential House Republicans panned the blueprint, and Trump offered conflicting reviews. The discord swiftly cast the plan\u2019s viability into serious doubt.<\/span><\/p>\n

In an address at a Heritage Foundation dinner in Washington on Tuesday, Trump commended \u201cthe bipartisan work\u201d of Alexander and Murray but suggested that a different kind of fix is needed.<\/span><\/p>\n

\u201cI continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies,\u201d Trump said.<\/span><\/p>\n

Earlier in the day, at a joint news conference with the prime minister of Greece, Trump sounded positive notes about the plan. \u201cYes, we have been involved, and this is a short-term deal,\u201d Trump said. He said the proposal would \u201cget us over this intermediate hump\u201d and allow Republicans to later revisit efforts to aggressively undo the ACA.<\/span><\/p>\n

In between those two appearances, the president tweeted: \u201cAny increase in ObamaCare premiums is the fault of the Democrats for giving us a \u2018product\u2019 that never had a chance of working.\u201d<\/span><\/p>\n

Trump stopped the CSR payments last week, arguing that the subsidies were illegal because they were not explicitly authorized under the ACA, and he instructed Congress to decide whether to appropriate the funding.<\/span><\/p>\n

\u201cNone of our guys voted for Obamacare,\u201d Rep. Tom Cole (R-Okla.), a close ally of House GOP leadership, said in an interview. \u201cThey\u2019re not very interested in sustaining it.\u201d<\/span><\/p>\n

A leading House conservative was outright hostile to the new bipartisan plan. \u201cThe GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable,\u201d said Rep. Mark Walker (R-N.C.) in a statement posted on Twitter. Walker is the chairman of the influential Republican Study Committee.<\/span><\/p>\n

Senate Republican leaders were less than enthusiastic.<\/span><\/p>\n

\u201cWe haven\u2019t had a chance to think about the way forward yet,\u201d said Senate Majority Leader Mitch McConnell (R-Ky.) at his weekly news conference, minutes after Alexander announced the deal about 20 feet away, outside a Republican policy luncheon.<\/span><\/p>\n

Alexander said the deal he struck with Murray would extend CSR payments for two years and provide states \u201cmeaningful flexibility\u201d under the ACA, allowing them to make changes to insurance offerings as long as the plans had \u201ccomparable affordability,\u201d which is a slightly looser definition than the existing one.<\/span><\/p>\n

In an interview, Senate Minority Leader Charles E. Schumer (D-N.Y.) said both parties made concessions to produce a deal that would \u201cstabilize the Affordable Care Act and undo a good amount of the sabotage that we\u2019ve seen in recent days.\u201d<\/span><\/p>\n

\u201cEach side had to give some, but that\u2019s what this is all about,\u201d Schumer added.<\/span><\/p>\n

The framework would also allow insurers to offer catastrophic insurance plans to consumers aged 30 and older on ACA exchanges, while maintaining a single risk pool. It would shorten the time period for federal review of state waiver applications, expedite review for states in emergency circumstances and those with waiver proposals that have already been approved for other states, and allow governors to approve state waiver applications rather than requiring state legislative approval.<\/span><\/p>\n

Alexander emphasized that the legislation would not allow states to change the essential benefits insurers are now required to offer individuals and small businesses under the ACA, or let insurers discriminate against consumers with preexisting conditions. \u201cThis takes care of the next two years,\u201d the senator said, standing off to the side as other GOP leaders stood before television cameras talking primarily about tax legislation. \u201cAfter that we can have a full-fledged debate on where we go long-term on health care.\u201d<\/span><\/p>\n

Trump\u2019s decision to halt CSR payments last Thursday came a week after he had called \u00adSchumer to ask him to \u201cwork together on a bipartisan solution to health care,\u201d in the senator\u2019s words, and had empowered Alexander to negotiate with Murray.<\/span><\/p>\n

Schumer said that he realizes Trump may push later on for repealing the ACA outright, \u201cand we will fight him tooth and nail.\u201d But he added, \u201cIn the short run, stability is in his interest, because otherwise its lands at his doorstep.\u201d<\/span><\/p>\n

Still, it remains unclear how Trump will choose to speak about the bipartisan deal in the coming weeks and days, and whether recalcitrant conservatives will come along.<\/span><\/p>\n

The first test will come in the Senate, where lingering hard feelings from the failed attempts to repeal and replace the ACA remain. Senate GOP leaders have moved on to tax cuts, their next big legislative undertaking.<\/span><\/p>\n

After Trump voiced his support for the health-care compromise, Sen. John Cornyn (R-Tex.), McConnell\u2019s top lieutenant, was unwilling to commit to it.<\/span><\/p>\n

\u201cI think Sen. Alexander\u2019s done good work. And to me, it really depends on a few things,\u201d said Cornyn, wondering aloud whether the proposal is \u201ccompatible\u201d with the GOP\u2019s larger repeal-and-replace goal.<\/span><\/p>\n

Earlier Tuesday, Sen. Lindsey O. Graham (R-S.C.), who was golfing with Trump on Saturday when the president discussed the prospect of negotiations on the phone with Alexander, said that even if a deal is struck, it may not be enough of an overhaul to satisfy core Republican voters.<\/span><\/p>\n

\u201cThat will be his challenge, how much is enough? I can\u2019t support the payments until you get some reform, but I realize that for the base, it\u2019s going to be about not keeping Obamacare in place,\u201d Graham told reporters.<\/span><\/p>\n

In advance of the deal\u2019s announcement, many Republican senators were already distancing themselves from the emerging plan.<\/span><\/p>\n

\u201cI don\u2019t know. I\u2019m not sure what the Senate should do,\u201d said Sen. Orrin G. Hatch (R-Utah) Tuesday morning.<\/span><\/p>\n

In the House, which passed an ACA repeal bill, there appeared to be even less appetite for a bill that bolsters an element of the law that they have pilloried for seven years without more forcefully rolling back other parts of it.<\/span><\/p>\n

\u201cThis is like we have to fix the Senate\u2019s failure,\u201d said Cole. Using a football analogy, he blamed Senate Republicans for fumbling the ball on the one-yard line.<\/span><\/p>\n

In the eyes of Cole and other leading Republicans, the party\u2019s congressional majorities were put at risk by the unsuccessful repeal push. With Trump\u2019s former chief strategist Stephen K. Bannon already threatening primary challenges against senators up in 2018, some fear that asking lawmakers to reinforce the bill they tried to undo is simply not a defensible position.<\/span><\/p>\n

On the other hand, doing nothing is also likely to spur criticism of the Republicans.<\/span><\/p>\n

As senators announced their agreement, a new analysis emerged Tuesday showing the large stakes for insurers in the short term if the cost-sharing payments are not restored. By the end of 2017, health plans will lose more than $1 billion nationwide, according to the analysis by Avalere Health, a Washington-based consulting firm.<\/span><\/p>\n

Both state and industry officials welcomed the prospect of a possible deal on the subsidies, but they also warned that it could come too late given that the 45-day open enrollment period for the ACA begins Nov. 1.<\/span><\/p>\n

The timing \u2014 just two weeks before the start of the fifth enrollment season for ACA coverage \u2014 could mean havoc back in states, where some insurance regulators already are reeling from Trump\u2019s decision to stop funding CSRs.<\/span><\/p>\n

\u201cIt is better for consumers to have CSRs funded, but the timing is so short I am concerned,\u201d said Tennessee Insurance Commissioner Julie Mix McPeak, the incoming president of the National Association of Insurance Commissioners. If the deal becomes law, she said, insurers would be able to lower their rates in ACA marketplaces, \u201cbut I don\u2019t know that we have time to do that before open enrollment.\u201d<\/span><\/p>\n

It appears likely that the vast majority of Senate Democrats will back the measure: Murray received a round of applause from her colleagues when she announced the details of the agreement in their weekly caucus lunch, according to participants, and no one expressed dissent.<\/span><\/p>\n

Still, Democrats said that they wanted to read the details of the bill. Sen. Chris Murphy (D-Conn.) said that the idea of expanding the availability of catastrophic plans on the ACA market and making state waivers easier to obtain \u201cis not insignificant.\u201d<\/span><\/p>\n

Even if Democrats embrace the plan in large numbers, Murphy said, Republicans could ultimately block its passage.<\/span><\/p>\n

\u201cIt is not a done deal that this agreement reached by Senators Alexander and Murray will ever become law,\u201d he said.<\/span><\/p>\n

Source:-\u00a0https:\/\/www.washingtonpost.com\/powerpost\/key-senators-reach-bipartisan-health-care-subsidy-deal-and-trump-expresses-support\/2017\/10\/17\/72be5b04-b355-11e7-a908-a3470754bbb9_story.html?utm_term=.e088bf2345b3<\/span><\/p>\n

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