24 hours later, Senate health deal all but completely dead

A Senate healthcare deal to extend critical ObamaCare payments to insurers appears all but completely dead just 24 hours after it was announced.

President Trump reversed course Wednesday and said he opposed the deal, while Speaker Paul Ryan’s (R-Wis.) office said the Senate should keep its focus on repealing and replacing President Obama’s signature law.

Sen. John Thune (S.D.), the third-ranking Senate Republican, acknowledged the deal had “stalled out.”

{mosads}Some Republican senators said they were working on changes to move the bill in a more conservative direction, but those efforts appeared to have little chance of success.

Democrats, who hailed the agreement on Tuesday, signaled they were preparing to blame Republicans for walking away from the deal crafted by Health Committee Chairman Lamar Alexander (R-Tenn.) and Sen. Patty Murray (Wash.), the panel’s top Democrat.

“Lamar and Patty came up with a deal,” Senate Democratic Leader Charles Schumer (N.Y.) told reporters. “This is the agreement.”

The compromise would provide two years of payments to insurers, compensating them for lowering the out-of-pocket health care costs of certain ObamaCare enrollees. Trump announced he was canceling the payments last week, arguing the previous administration lacked the authority to make them.

Without the payments, the Congressional Budget Office has said premiums could rise as much as 20 percent, and enrollment would likely fall.

Democrats say Trump is seeking to sabotage the law by ending the payments, along with other administrative moves he’s made that they say could damage ObamaCare.

The Alexander-Murray language would also grant states more flexibility to waive ObamaCare rules, a key Republican ask. Lower-cost insurance plans that provide fewer benefits, known as copper plans, would be allowed.

In a nod to Democratic demands, it would provide states with $106 million to fund ObamaCare outreach. Trump had slashed the money for advertising by 90 percent. 

Conservatives have called the payments to insurers a bailout, an argument echoed by Trump on Wednesday.

In response, Alexander said that he was open to adding any language the White House might have to strengthen a provision already in the bill to ensure that insurers can’t keep the payments for themselves, but rather have to pass savings on to consumers in the form of rebates or another mechanism.   

Alexander has been trying to rally support by warning Republicans that premiums would increase 20 percent without the insurer payments and there would be chaos in the market. There’s not much time left, as ObamaCare’s exchanges open for business Nov. 1. 

Sen. Ron Johnson (R-Wis.) said he is pushing for more sweeping changes to move the bill to the right, and has spoken with Alexander. 

Johnson is seeking to increase the duration of short-term health plans; expand health savings accounts; not enforce the employer mandate; and waive the individual mandate penalty for 2017. 

Johnson argues he’s working to shore up conservative support in the House.

“[Alexander and I] are both interested in getting a result,” Johnson told reporters Wednesday. “He’s dealing with the hurdle of the Senate. I’m trying, to some extent, to deal with the hurdle in the House and maybe both of our efforts can come together and show members of Congress that this is what we’re going to need to do to really alleviate the increasing premiums, which are going to hurt Americans.”

It seems unlikely that Democrats will agree to any of those demands, however.

Schumer blasted Trump for reversing course after the president had previously made phone calls to Alexander encouraging the talks. He warned that ObamaCare was becoming TrumpCare given the administration’s actions, and that the GOP would own it.

“The president’s in charge,” Schumer said. “Republicans have the House and Senate. If there’s problems in the healthcare system, it falls on their shoulders.” 

Many observers think folding the deal into a government funding bill in December is its best chance of passage. Schumer said that is one option, though he held out hope the agreement could pass before then. 

Only a handful of Republicans, Sens. Lisa Murkowski (Alaska), Mike Rounds (S.D.), John McCain (Ariz.) and Bob Corker (Tenn.), have said they support the deal. Murkowski and McCain voted against the a scaled-down ObamaCare repeal bill in July, helping to sink the measure. 

“Obviously until the president’s on board, yes there are probably changes that need to be made to satisfy the president,” Sen. John Cornyn (R-Texas), the No. 2 Republican, said. “I think the president’s support is going to be key.”