Even with Obamacare repeal having failed again in the Senate, some Republican lawmakers say the Trump administration should not encourage Americans to obtain health insurance under the law’s exchanges.
“Absolutely not. I exempted my own staff from that,” Sen. Richard Shelby (R-AL) told The Daily Beast at the Capitol on Tuesday. “I wouldn’t want anybody under that.”
More than a dozen other Republican senators interviewed for this story were more equivocal than Shelby, but were still skittish about the law on its merits and the idea of people obtaining coverage through it.
“With the uncertainty of it, not necessarily,” Sen. Thom Tillis (R-N.C.) told The Daily Beast when asked if the administration should be pushing Americans to sign up. “I, for one, think that the American people need to know that we’ve got to come up with a fix to Obamacare, so if they have some personal need now, they can make that choice. But we’ve got to change the plan.”
Elected Republicans might have failed, for the time being, to replace Obamacare with a new health care system. But their opposition to the law has clearly yet to fade. The statements from Shelby, Tillis and others illustrate a party still highly distrustful of the Affordable Care Act—to the extent that they’re discouraging their own constituents from purchasing health insurance.
Their statements also suggest a level of comfort with attempts by the Trump administration’s to undermine Obamacare.
In recent weeks, the Trump administration has taken significant steps toward that end. The Center for Medicare and Medicaid Services cut back state funds meant to help individuals enroll in Obamacare. Ad budgets to promote enrollment have been slashed by 90 percent. And as The Daily Beast exclusively reported, the Department of Health and Human Services has used funds meant for promoting the law to instead undermine public confidence in it.
Democrats have decried the effort as a deliberate attempt at sabotage. But Republicans have expressed no such revulsions, with some arguing that it simply facilitates a foregone conclusion: that Obamacare will collapse on its own.
Congress does not “have the tools available to us to fix” Obamacare, and the law will eventually “fail under its own weight,” Sen. Mike Rounds (R-S.D.) told The Daily Beast, adding that the Trump administration should refrain from “making promises to the American public because clearly it’s not going to continue on very long.”
Though insurance premiums have risen under Obamacare—as they did before the law was passed—insurers and health care experts attribute it to a variety of factors. This includes the Trump administration’s refusal to embrace policies necessary for making the insurance exchanges run more smoothly. In particular, those experts say the administration has created uncertainty by refusing to extend Obamacare subsidies—known as cost-sharing reduction (CSR) payments—on a long-term basis. After weeks of threatening to cut off the subsidies, the White House decided in August to extend them on a short-term basis after pressure from both Democrats and Republicans.
Despite calls for continuing the subsidies in the long term, some Republican lawmakers are dismissing allegations that the Trump administration is undermining Obamacare by not committing to their payment.
“I think Obamacare itself is sabotaging enrollment because the costs are so high, the choices are so limited that people realize it’s not a good deal for them personally,” Sen. John Barrasso (R-WY) said.
Though critics insist that the law is doomed to fail, a select few Republicans have expressed openness to bipartisan reforms. Talks between the leaders of the Senate’s health committee stalled just two weeks ago amid the GOP’s latest attempt to repeal and replace the law. But Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), the committee’s chairman and ranking member, have since renewed discussions, and an agreement could come soon.
Murray told The Daily Beast that she and Alexander were “extremely” close to a deal before reaching a stalemate.
Even if Murray and Alexander reach an agreement, they still face hurdles. They do not yet have a guarantee from Republican leadership that a proposal would be brought to the floor, nor do they have a similar guarantee from House Speaker Paul Ryan. Even if both chambers pass the stabilization package, Trump could veto it.
“What we’re trying to do—and I appreciate the way Sen. Murray is doing it—we’re trying to find not just an agreement between the two of us, because that won’t do anything,” Alexander said on Tuesday. “We’re trying to find a significant number of Republicans and Democrats who agree on a limited bipartisan consensus to stabilize the market in 2018 and 2019. That means keep premiums lower in 2018 and hopefully reduce them in 2019.”
Alexander has said that the bipartisan package would likely include a two-year extension of the CSR payments, in addition to measures that would give individual states more flexibility when it comes to their own health care systems. But when asked if the administration should encourage enrollment in the meantime, Alexander said market stabilization should be the priority.
“I’m going to focus on getting a result here and that we won’t have to worry about that,” Alexander told The Daily Beast. “What we’re trying to do is consistent with Graham-Cassidy because Graham-Cassidy would not have taken effect until 2020 or 2021. And we’re working on the interim.”