The GOP Break From Trump May Be Starting
Health care reform may be off the table for the near future, but that doesn’t mean bipartisan efforts to fix the system aren’t percolating just under the surface.
Congressional Republicans broke dramatically with the White House on Tuesday over the future of health care reform, with lawmakers entertaining bipartisan talks as the president scrambled for a way to salvage Obamacare repeal and replace efforts.
The talks aren’t expected to yield a quick legislative fix to Obamacare. Instead, Sen. Lamar Alexander (R-TN), the chairman of the Senate Committee on Health, Education, Labor and Pensions, said his committee would simply be holding hearings on possible actions Congress could take to stabilize the health insurance markets.
But the fact that talks were happening at all was a remarkable break from the message that the president and his team were hoping to send. While Senate Majority Leader Mitch McConnell (R-KY) spoke in the past tense during a press conference on Tuesday to discuss his party’s efforts to pass Obamacare repeal—“our problem on health care was not the Democrats; we didn't have 50 Republicans”—the administration was continuing to press Republicans to keep at it.
“There are not the votes in the Senate, as I’ve said repeatedly to the president and to all of you, to change the rules of the Senate. There’s not enough even to require 50 or 51 Republicans to agree to do that. The votes are simply not there,” McConnell told reporters.
Trump held talks on Monday with Arizona Gov. Doug Ducey, ostensibly to convince him to get his home state senator, John McCain, to drop opposition to the last Senate bill. And an administration official told The Daily Beast that, “the President wants the Senate to act by fulfilling its promises to repeal and replace Obamacare.”
The official wouldn’t specify if the president’s hope was for the Senate to act before it leaves for August recess. But the likelihood of that happening is next to nil. Not only is McCain unlikely to return to Washington D.C. as he undergoes treatment for recently-diagnosed brain cancer; but lawmakers are already plotting negotiations for when they get back after Labor Day.
Alexander’s hearings will take place in September, during which the committee plans to hear from state insurance chiefs, governors, health care experts, and representatives from the insurance industry. In the interim, the senator has asked Trump to authorize a short-term stabilization measure known as cost-sharing-reduction (CRS) payments in order to buy Congress time to come up with a bipartisan solution.
Were he speaking on his own, Alexander’s statement would constitute a stinging rebuke of the president’s demand that Congress either take another stab at repeal-and-replace or, absent that, let Obamacare “implode.” But he was joined by several other high-ranking Republicans too. Sen. John Thune (R-S.D.) also encouraged Trump to make the CSR payments, as did Sens. Bill Cassidy (R-LA) and Bob Corker (R-TN).
“There would be a lot of poor people that would, obviously, be negatively affected. And when you’re president, you’re president of the whole country. And while you might be dissatisfied with what you inherited, typically it’s best to try to figure out a way to move ahead in a manner that doesn’t harm folks,” Corker told The Daily Beast.
Even Sen. John Cornyn (R-TX), the Senate Majority Whip who, next to McConnell, pushed hardest for a repeal-and-replace vote, acknowledged in a floor speech on Tuesday that the path forward on reform would have to be with Democratic contributions.
The fissure on health care between Senate Republicans and the White House presented Democrats with a rare political opening, but not one without its own set of complications.
Several Democratic aides told The Daily Beast that the party is eager to craft a modest deal with Republicans both as a means of stabilizing the individual insurance marketplace and removing the possibility that the GOP returns to a broader repeal-and-replace push—since the case or one would be weakened by the modest deal they struck. But they also recognize that the advocacy community that helped defeat Republican efforts to overhaul Obamacare will be less-than-pleased with legislation that weakens the law, even on the margins. And they aren’t entirely confident in the GOP’s ability to withstand Trump’s pressure to keep trying to uproot the Affordable Care Act.
"Yes, I do [worry that it will come back],” Sen Mazie Hirono (D-HI) told The Daily Beast. “And while we are worrying about that, I think the administration and [President] Trump made it clear they are going to do what they can to probably sabotage the Affordable Care Act. And when he said that the Affordable Care Act should implode that was definitely a message to HHS Secretary] Tom Price and others that they should slow walk and do those things that would sabotage the law.... So, yes, the fight is not over."
Trump is expected to decide as soon as this week on whether to extend the CSR payments, which help offset costs for insurers and poorer Americans. If the president axes those payments, experts and lawmakers have warned that premiums could skyrocket and even more insurers could leave or threaten to leave the exchanges.
For Democrats, a prerequisite to crafting bipartisan reform is for the administration to alleviate that uncertainty.
“The idea that we’re doing this to just help insurance companies is hogwash. We would help the treasury, and frankly, we would be helping a lot of the people who are getting coverage in the exchanges,” Sen. Tom Carper (D-DE), a former governor who has helmed talks with Republicans for weeks, told The Daily Beast. Carper added that he hopes new White House Chief of Staff John Kelly “will talk some sense” into Trump.
The president has cast Obamacare’s “implosion” as a mechanism to get Democrats to the table. If Trump sabotages the existing law, Carper said, Obamacare’s success or failure will rest on his shoulders.
“We have an old saying in Delaware: if you break it, you own it,” said Carper. “And if he breaks it, he will own it. And ironically and cruelly, some of the people who will suffer the most are the people who live in those red states that voted for him, including West Virginia and Kentucky and places like that.”