Alexander Points Finger At Trump As Opposition to Obamacare Deal Mounts

Sen. Lamar Alexander’s (R-Tenn.) deal to stave off the collapse of Obamacare is meeting with a less than ecstatic response. As the bipartisan framework meets opposition, Alexander pointed to President Trump as the force behind the tentative agreement.

After a phone call with the president, Sen. Alexander claimed that the deal was Trump’s idea in the first place. “Trump completely engineered the plan that we announced yesterday,” Alexander told Mike Allen of Axios. Alexander said that Trump repeatedly called to push him toward a deal that included Sen. Patty Murray (D-Wash.). “He wanted a bipartisan bill for the short term,” Alexander said.

A few minutes after Alexander’s appearance with Allen, President Trump appeared to throw then senator under the bus. Trump tweeted, “I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co’s who have made a fortune w/ O’Care.”

Meanwhile, there are signs that the deal may be a tough sell for Republicans. A spokesman for Speaker Paul Ryan said, “The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare.”

Business Insider reported that Senator Orrin Hatch (R-Utah) had announced that he would oppose the Obamacare deal. Hatch, who penned an op-ed in the Washington Post entitled, “Obamacare doesn’t deserve a bailout,” told reporters, “It would last two years and spend a whopping amount of money and not solve the problem.” John Thune (R-S.D.), the Senate’s third highest ranking Republican, said that the bill had “stalled out.”

The effort did pick up several cosponsors as Senators Bob Corker (R-Tenn.), John McCain (R-Ariz.) and Susan Collins (R-Maine) signed on to the bill. There were reports that more cosponsors from both parties would announce their support soon.

The bill could pass with combined support of Republicans and Democrats, even if a large number of conservatives withhold their support. Small Republican majorities in both houses make it difficult to pass a unilateral bill. Republicans alone do not have the numbers to win a cloture vote in the Senate and the loss of only three senators is enough to scuttle a budget resolution that requires only a simple majority to pass. However, a bipartisan coalition could conceivably muster enough support to win a vote as well as end a filibuster by holdouts.

At this point, Majority Leader Mitch McConnell (R-Ky.) has not indicated his position on the deal. As leader of the Senate, McConnell could doom the bill by preventing the Senate from bringing it to a vote.

If the bill dies, the Trump Administration has announced that it will suspend Obamacare subsidy payments to insurance companies in accordance with a federal court decision earlier this year. The effect that this would have upon insurance markets is uncertain, but insurance company stocks tumbled after the president announced the decision.

Sen. Alexander said that Republicans may reintroduce the Graham-Cassidy bill if the Alexander-Murray deal fails. Graham-Cassidy was withdrawn last month after four Republican senators announced that they would vote against it.

Bipartisan Deal Would Preserve Obamacare For Two Years

In an “if you can’t beat them, join them” moment, Republicans appear to have reached a deal with Democrats to preserve key components of the Affordable Care Act in the wake of President Trump’s announcement that his administration will stop paying subsidies to insurance companies under the Obama-era law. The tentative agreement was announced by Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) on Tuesday.

“Sen. Murray and I have an agreement. We’re going to round up co-sponsors as best we can,” Alexander told Politico.

President Trump appeared optimistic about the deal. “Lamar has been working very, very hard with the Democratic, his colleagues on the other side,” Trump said. “And they’re coming up and they’re fairly close to a short-term solution. The solution will be for about a year or two years. And it’ll get us over this intermediate hump.”

The deal reportedly contains funding for Obamacare’s subsidies to insurance companies for 2017, 2018 and 2019 as well as funding for state Obamacare enrollments. In return, Republicans would get expanded access to state waivers to approve lower cost plans and consumers over 30 would be allowed to purchase “copper plans” that cover only catastrophic illnesses for a lower premium, but have higher out-of-pocket costs.

There would also be an important advantage for Republicans in postponing the shakeout of the insurance industry that would accompany stopping the subsidy payments. No one knows precisely what would happen if the Trump Administration stopped the payments, but the likely chaos in insurance markets would probably not reflect well on Republicans as midterm elections approach. The deal would give Congress two additional years to resolve the issue.

Whether the bill can pass Congress is uncertain. Chairman of the House Republican Study Committee, Rep. Mark Walker (R-N.C.) tweeted, “The GOP should focus on repealing and replacing Obamacare, not trying to save it. This bailout is unacceptable.” Others, such as Sen. Ted Cruz (R-Texas), adopted a wait and see attitude.

“Most of the members of the conference are finding out about the details for the first time. I don’t think anybody beyond Lamar and a few others know,” Sen. John Kennedy (R-La.) said. “The details are important.”

Senate Minority Leader Chuck Schumer (D-N.Y.) seemed to favor the bill. “We think it’s a good solution and it got broad support when Patty and I talked about it with the caucus,” he said. “We’ve achieved stability if this agreement becomes law.”

If Schumer and Nancy Pelosi (D-Cal.) can deliver Democrat votes, the bill could become law in spite of almost certain opposition by conservative Republicans. At this point, it seems likely that Democrats would favor the bill, which would preserve most of Obamacare intact and force the Trump Administration to continue paying subsidies.

At this point, there is no indication of how fast the bill will move through Congress. Majority Leader Mitch McConnell (R-Ky.) said, “We haven’t had a chance to think about the way forward yet.” Speaker of the House Paul Ryan (R-Wisc.) has not publicly addressed the new deal, but told the Milwaukee Journal-Sentinel on Monday that he preferred a comprehensive approach to replacing the Affordable Care Act.

“I think we’ve got to do more to get it fixed, but the answer is not to shovel more money at a failing program that is doubling premiums and causing monopolies,” Ryan said. “The answer is to reform the underlying failure of the law and one of those underlying failures is the lack of choice and competition in health insurance.”

Is Trump’s Obamacare Executive Order Constitutional?

There has been a lot of discussion about President Trump’s healthcare Executive Order. Most of the discussion centers around the likely effects of the order while little has been said about the constitutionality of Trump’s executive action. For a party that roundly condemned President Obama’s abuse of executive authority, a big question should be whether Trump has the legal authority to make the changes that he proposes.

The bottom line is that Trump’s Executive Order doesn’t actually make any changes to the Affordable Care Act. What it does do is to order cabinet secretaries to “consider proposing regulations or revising guidance, consistent with law.” In other words, Trump isn’t proposing changes to laws passed by Congress, he is considering changes to regulatory laws enacted by bureaucrats. These changes will be “considered” in three main areas.

First, the president wants to expand access to association health plans (AHPs). Health Affairs notes that these plans are more loosely regulated than traditional insurance plans. They are normally regulated by the states, but can be regulated by the federal government in the case of some national associations. The order instructs the Secretary of Labor to “consider” expanding the definition of “employer” under ERISA to allow more groups to sell AHPs and to “promote AHP formation on the basis of common geography or industry.” To purchase insurance, consumers would have to be a member of the association.

Second, the Executive Order moves to expand Short-Term, Limited-Duration Insurance (STLDI) policies. The order notes that STLDIs are “exempt from the onerous and expensive insurance mandates and regulations” of the Affordable Care Act, but that “the previous administration took steps to restrict access to this market by reducing the allowable coverage period” to less than three months. “To the extent permitted by law and supported by sound policy,” the president directs cabinet members to “consider allowing such insurance to cover longer periods and be renewed by the consumer.”

STLDIs are not considered to be individual health insurance policies and do not have to meet the insurance policy requirements of the Affordable Care Act. The policies are governed by rulemaking agencies of the Department of the Treasury, Department of Labor, and Department of Health and Human Services. Therefore, these departments can amend the rules for STLDIs without going through Congress.

Third, the Executive Order instructs relevant cabinet secretaries to “consider proposing regulations or revising guidance, to the extent permitted by law and supported by sound policy, to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.”

HRAs are health reimbursement accounts. They allow employers to contribute money on a pre-tax basis to reimburse employees for health insurance premiums and out-of-pocket expenses. HRAs were created by Congress, but executive branch agencies have leeway in how to regulate them.

President Trump’s decision to halt Obamacare subsidies to insurance companies is not part of the Executive Order, but is on firm legal ground. House Republicans sued the Obama Administration over the subsidies in 2014. In May 2016, a federal judge ruled that Congress had authorized the payments, but had never appropriated money for them. The Obama Administration appealed the ruling, but the decision by President Trump seems to be merely accepting the court’s initial decision and dropping the appeal.

This doesn’t mean that the Trump Administration will be able to stop making the payments. Several states ultimately joined the appeal, claiming that the Trump Administration was not adequately defending their interests. Now 18 states have filed a new lawsuit seeking an injunction against President Trump’s decision.

Because the President Trump’s Executive Order does not change existing law and only instructs cabinet members to “consider” making changes to bureaucratic regulations within the framework of the law, the order is constitutional. It remains to be seen what regulatory changes the various cabinet secretaries will propose, but the changes will probably be much less sweeping than claimed by either right or left-wing pundits.

President Trump’s Executive Order is legal in large part because it doesn’t do much. The president simply does not have much authority to change laws that have been passed by Congress. The decision to stop insurance company subsidies is a more serious threat to Obamacare, but even this is unlikely to take effect until the lawsuit by the states is settled.

BREAKING: Trump Deals With Schumer On Healthcare

In an early morning tweet, President Donald Trump made the shocking revelation that he was in negotiations with Sen. Chuck Schumer (D-N.Y.) on reforming Obamacare.

In the tweet, Trump said, “I called Chuck Schumer yesterday to see if the Dems want to do a great HealthCare Bill. ObamaCare is badly broken, big premiums. Who knows!”

No specifics on the potential deal were announced. The president also did not say when further details would be available.

Republican attempts to pass a healthcare bill recently failed in the Senate. Senators Rand Paul (R-Ky.), John McCain (R-Ariz.), Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) had announced that they would not vote for the bill.

Any deal with Democrats would be certain to leave the core of Obamacare intact. While many Republicans would likely oppose such a bill, a bipartisan coalition of Democrats and Trump supporters in the GOP could form a majority. It is possible that such a coalition could even get enough votes to end a filibuster.

 

 

NEW: Cassidy Responds To Attack By Jimmy Kimmel

Senator Bill Cassidy (R-La.) has responded to Jimmy Kimmel’s charge that Cassidy “lied right to my face” about health care reform. On MCNBC’s “Morning Joe” and a separate CNN interview, Cassidy claimed that the Graham-Cassidy bill does meet the “Jimmy Kimmel test.”

“I’m sorry he does not understand,” Cassidy said. “More people will have coverage and we protect those with pre-existing conditions.”

The Graham-Cassidy bill allows states to apply for waivers from Obamacare’s essential health benefits requirement. The bill would require that states exercising waivers to show that coverage would still be “adequate and affordable” for those with pre-existing conditions. Kimmel and other critics argue that this requirement is too weak and vague to offer protection.

“The counterargument will be pre-existing conditions will be up to the pricing of the particular state and market,” countered CNN’s Chris Cuomo. “So, the protection is not the same, senator, on that one point.”

“The protection is absolutely the same,” Cassidy answered. “There is a specific provision that says that if a state applies for a waiver, it must ensure that those with pre-existing conditions have affordable and adequate coverage.”

Cuomo argued that people with pre-existing conditions would pay more, based on a schedule of rates being circulated.

“I think the price will actually be lower,” Cassidy responded. “What is being circulated is by those that wish to preserve Obamacare and they’re doing everything they can to discredit the alternative.”

The Congressional Budget Office is currently scoring the bill, but because the budget resolution must be passed before the end of September, the analysis will be incomplete. “CBO will not be able to provide point estimates of the effects on the deficit, health insurance coverage, or premiums for at least several weeks,” the office said in a statement.

“There will be more people covered under this bill than under the status quo,” Cassidy claimed.

Jimmy Kimmel Rips Bill Cassidy Over Health Bill

Late night host Jimmy Kimmel veered off into leftist politics again last night when he ripped into Senator Bill Cassidy (R-La.). In a seven-minute monologue on Jimmy Kimmel live, Kimmel charged that Cassidy “lied right to my face” about promises that he made to Kimmel regarding Obamacare reform in an appearance on the show in May.

The controversy centers over Cassidy’s promise that a healthcare reform bill would meet the “Jimmy Kimmel test,” a term that Kimmel says was coined by the senator. “In a nutshell,” Kimmel said, the test holds that “no family should be denied medical care — emergency or otherwise — because they can’t afford it.”

“He said he would only support a healthcare bill that made sure a child like mine would get the health coverage he needs,” Kimmel continued, “no matter how much money his parents make, and that did not have annual or lifetime caps.”

Cassidy appeared on Kimmel’s show in response to another monologue in which Kimmel described how his infant son required heart surgery that could be considered a pre-existing condition.

Dr. James Madara, president of the American Medical Association, wrote in Fortune that the bill could possibly allow states to opt out of affordable coverage for pre-existing conditions. “While insurers are still required to offer coverage to patients with pre-existing conditions,” Madara wrote, “allowing states to get waivers to vary premiums based on health status would allow insurers to charge unaffordable premiums based on those pre-existing conditions.”

Kimmel said that the Graham-Cassidy bill passed a different Jimmy Kimmel test. “Your child with the pre-existing condition will get the care he needs if – and only if – his father is Jimmy Kimmel. Otherwise, you might be screwed,” he joked.

While the bill does not eliminated coverage for pre-existing conditions or allow insurance companies to establish caps for lifetime benefits, the bill does return the power to regulate insurance to the states. Politico notes, “States would be allowed to apply for waivers that could change what qualifies as an essential health benefit,” a term originally defined by the Affordable Care Act. The waivers could “impact people with pre-existing conditions and undermine prohibitions on annual and lifetime limits for insurance coverage.”

Kimmel thanked Senators Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and John McCain (R-Ariz.) for voting to kill the previous Republican healthcare bill. He urged the trio to vote against Graham-Cassidy as well.

In a part shot, Kimmel invited Cassidy to work for a health care bill that met with Kimmel’s approval, “and if not, stop using my name, because I don’t want my name on it.”

“There’s a new Jimmy Kimmel test for you,” Kimmel scolded Cassidy. “It’s called a lie detector test. You’re welcome to stop by the studio and take it anytime.”

Republican Senators Try a ‘Hail Mary’ On Obamacare

After their embarrassing failure to repeal and replace Obamacare over the summer, Republicans in the Senate are gearing up for a “Hail Mary” attempt to at least make a modicum of reforms to the health care law. The Senate, where the previous attempt to rein in Obamacare died, may vote on the last-gasp effort by the end of September.

As explained previously in The Resurgent, Republicans cannot fully repeal Obamacare without 60 votes. The previous attempt at reforming Obamacare fell apart over details of how the law’s subsidies should be treated and how to handle medical care for the uninsured. Moderate Republican support for the ACA’s expansion of Medicaid also caused serious problems in crafting a replacement bill.

The new bill, written by Senators Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), is much more modest than the failed American Healthcare Act. The proposal doesn’t completely repeal Obamacare, but does replace Obamacare’s tax subsidies with state block grants, repeals the individual mandate and scales back the Medicaid expansion.

“It’s basically federalism where you just block grant the whole thing,” Speaker Paul Ryan (R-Wisc.) told the Washington Examiner. “You block grant Obamacare back to the states. Just the whole thing.”

Majority Leader Mitch McConnell (R-Ky.) has indicated that he will bring the bill to the floor for a vote if at least 50 of the 52 Republican senators support it. At the moment, the bill is short of that mark, but Politico reports that it is gaining steam after Graham publicly lobbied President Trump and others. Estimates put Republican support for the bill at 48 or 49 senators.

The bill appears to be on a fast-track. The Washington Post reports that Republicans have already submitted it to the Congressional Budget Office for analysis. If the bill is not passed before the end of September, the Post notes that the authority to pass the legislation with a simple majority under budget reconciliation rules would expire. This would effectively kill any attempts to reform Obamacare until next year.

If the bill does pass the Senate, it faces an uncertain future in the House of Representatives. The previous bill, which originated in the House, had to be finely tuned to pass by a slim majority. Under budget reconciliation rules, the House would have to pass the Graham-Cassidy bill with no changes.

No Democrats are expected to support the bill. Sen. Elizabeth Warren (D-Mass.) tweeted, “The Graham-Cassidy @SenateGOP ‘health care’ bill IS Trumpcare, & it will rip health care away from millions of Americans.”

As with the previous Obamacare reform bill, opposition to the bill is expected to come from the right as well as the left. Senator Rand Paul (R-Ky.) has announced that he will oppose the bill, calling it “Obamacare lite.” If Paul stands firm, the defection of any other Republican will doom the bill.

Paul’s stance against “Obamacare lite” begs the question of whether he and the Freedom Caucus would prefer the full version of Obamacare to an imperfect Republican reform bill. For the foreseeable future, those are the only two options.

Bernie Sanders to Introduce Medicare-For-All Bill

In an op-ed for the New York Times, Senator Bernie Sanders (I-Vt.) says that he plans to introduce a bill that would replace private health insurance with Medicare for “every family in America.” Sanders, who bills himself as a democratic socialist, believes that the answer to the Obamacare crisis is more government control of the nation’s healthcare.

Under the Sanders plan, a four-year transition period would move the country from private health insurance to a national single-payer plan. Sanders describes the details of the transition:

“In the first year, benefits to older people would be expanded to include dental care, vision coverage and hearing aids, and the eligibility age for Medicare would be lowered to 55. All children under the age of 18 would also be covered. In the second year, the eligibility age would be lowered to 45 and in the third year to 35. By the fourth year, every man, woman and child in the country would be covered by Medicare for All.”

Sen. John Barasso (R-Wy.) pre-empted many of Sanders’ arguments in a Tuesday op-ed on Fox News. Barasso, a medical doctor, pointed out that single-payer plans in other countries have not worked out well. “The British have found rationing necessary partly because of the exorbitant cost of ‘free’ medical care,” he wrote. Barasso also cited “the shortage of professionals to provide this care” as the number of British doctors, nurses and midwives has dropped in recent years.

While Sanders and others cite poor outcomes of American healthcare, Barasso points out, “The U.K. ranks 20th out of 24 western countries for breast cancer survival. The U.S. is first. For ischemic stroke the U.K. is 25th out of 30 countries. The U.S. is fourth.”

While Sanders’ proposal will be a nonstarter in the Republican-controlled Congress, it could portend things to come if Democrats return to the majority. Opinion polls in recent months have indicated a growing support for a federal role in healthcare. Pew Research found that 60 percent of Americans say that it is the federal government’s responsibility to ensure healthcare coverage for all Americans. Last spring, an Economist/You Gov poll found that that 60 percent favored a Medicare-for-all approach. That number includes 40 percent of Trump voters.

While most conservatives and Republicans will ridicule Sanders’ proposal as radical and dead-on-arrival, the idea of Medicare-for-all might have broader appeal than they suspect. If conservatives do not confront the idea head-on by enacting a better proposal, it is very possible that Republicans could face an invigorated Democratic Party in 2018 and 2020.

It is a cautionary tale to recall that Republicans defeated Hillarycare in the 1990s, but then failed to enact healthcare reforms of their own during the Bush Administration. That failure led directly to the election of Barack Obama and the Affordable Care Act.

Don’t miss out. Like us on Facebook and follow us on Twitter.