Days after President Trump took concrete steps to sabotage Obamacare, opening loopholes to allow people to purchase unregulated insurance and cutting off payments to insurers that offset the cost of covering poor Americans, Trump revealed what passes for a strategy in his administration. He reportedly called Republican senator Lamar Alexander last week and told him he wants to see legislation that restores the cost-sharing reduction payments he just cut off. Trump even told reporters, “Republicans are meeting with Democrats because of what I did with the CSRs — because I cut off the gravy train” — suggesting he deserves credit for bipartisan talks that have been under way for months. (A day later, he posted a counterproductive tweet attempting to blame Democrats for the consequences of ending CSR payments.)
It’s too late for Trump to task Congress with fixing the problem he created (his go-to maneuver these days), as he cut off CSRs just two weeks before the start of the Obamacare marketplaces’ 2018 open enrollment period. Even if Congress took action tomorrow, it probably wouldn’t prevent huge premium increases next year.
Another reason Congress can’t help Trump out of this mess: They simply don’t want to. On Tuesday, Alexander and Democratic senator Patty Murray announced they’d reached a deal to stabilize Obamacare for the time being by funding the subsidies for two years. The Washington Post has a rundown of the other terms of the agreement:
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.
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.
Though Trump responded by declaring the Affordable Care Act “virtually dead” once again, he seemed to support the deal. “It’ll get us over this intermediate hump,” he said during a White House press conference on Tuesday, calling it “a short-term solution so that we don’t have this very dangerous little period.”
Most Senate Democrats seemed enthusiastic about the plan, but it appears Trump’s inconsistent backing of the measure failed to inspire Republicans. The Post reports that Senate leaders, who made multiple failed attempts to repeal and replace Obamacare, were noncommittal. “We haven’t had a chance to think about the way forward yet,” Senate Majority Leader Mitch McConnell said, minutes after the deal was announced. Senator John Cornyn, the majority whip, said, “I think Senator Alexander’s done good work. And to me, it really depends on a few things.” He then wondered if stabilizing Obamacare is “compatible” with the GOP’s long-term goal of destroying the law.
Republicans in the House, who eventually passed an Obamacare repeal bill in May, were more openly hostile.
“None of our guys voted for Obamacare,” said Representative Tom Cole. “They’re not very interested in sustaining it.”
Representative Mark Walker, chairman of the Republican Study Committee, tweeted: “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”
Further efforts to repeal Obamacare appear to be on the back burner after last month’s failed push to pass the Graham-Cassidy bill. For now, many Republicans seem content to focus on tax cuts and hope people buy Trump’s effort to shift the blame to Democrats. Senator Thom Tillis worried that the health-care deal might be a distraction, warning, “We don’t want to shift our focus away from tax reform.”
“In my view, this agreement avoids chaos,” Alexander said while pitching the plan on Tuesday. “And I don’t know a Democrat or a Republican who benefits from chaos.” He might want to place another call to President Trump.
