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.”

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.

McConnell Criticized For Pelosi-Like Tactics On Health Bill




Majority Leader Mitch McConnell (R-Ky.) is facing questions about his leadership after the Obamacare repeal debacle. Many Republican senators are criticizing McConnell’s strategy of crafting the bill in secret without input from members of the GOP caucus.

Lisa Murkowski (R-Alaska), a consistent no vote on health care reform, said that she was often in the dark about what the most current version of the bill contained and lamented that she didn’t have time to study the draft legislation before voting.

In a situation reminiscent of Nancy Pelosi’s statement that Congress needed to vote on Obamacare to see what was in it, Murkowski told The Hill that, under McConnell, it was like “It’s 10 o’clock and we’re going to vote on it in two hours, what do you think, gang?”



John McCain (R-Ariz.), who cast the deciding vote to kill the healthcare bill, cited the secrecy surrounding the drafting of the bill as a reason to vote against it. McCain said in a statement, “We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition. I don’t think that is going to work in the end. And it probably shouldn’t.”

Other senators agreed with Murkowski’s criticism of the closed-door drafting of the legislation. In June, Sen. Mike Lee (R-Utah) said in a Facebook video, “Even though I’ve been a member of this working group among Senate Republicans assigned to help narrow some of the focus of this, I haven’t seen the bill.”

“And it has become increasingly apparent in the last few days that even though we thought we were going to be in charge of writing a bill within this working group, it’s not being written by us,” Lee continued. “It’s apparently being written by a small handful of staffers for members of the Republican leadership in the Senate.”

Ron Johnson (R-Wis.) went further a few weeks later. After a report by the Washington Post that McConnell told moderate Republicans that Medicaid cuts in the bill would not happen because they are so far into the future, Johnson told the Green Bay Press-Gazette that McConnell’s comments were a “breach of trust.”

Even without arousing the anger and suspicion of Republican senators, there was always a narrow window to pass an Obamacare reform bill. The Republican majority of only two votes meant that McConnell “needed to pitch a perfect game,” one senator told The Hill. “Unfortunately, he pitched a two-hitter,” the senator continued.

The criticism doesn’t mean that McConnell’s leadership will be challenged anytime soon. No Republicans are stepping up to contest the Kentucky Republican’s position at the helm of the Senate. As Republican failures mount, that could change.

It is widely expected that the next step for the GOP is to tackle tax reform, an issue that faces many of the same challenges as healthcare reform. If Republicans use the budget reconciliation to avoid a Democrat filibuster, permanent changes would have to be scored as not adding to the deficit by the Congressional Budget Office. As with the healthcare bill, Republican moderates will be under intense pressure from the media and Democrats and it will only take three Republican defections to kill the bill since no Democrats are expected to vote yes.

After six months of stinging defeats in Congress, Republicans badly need a legislative victory to shore up the conservative base. Republican voters are angry at what they see as a betrayal of one of the party’s core promises. If Republicans can show no results from their majorities in both houses of Congress, Republican voters may stay home in November 2018. That could imperil McConnell’s position as majority leader even more surely than a revolt among Republican senators.

The Skinny On The Failure of Skinny Repeal

 

The last-ditch Republican effort to repeal the Affordable Care Act, the so-called “Skinny Repeal,” went down in flames last night as expected. In truth, the Obamacare repeal effort has been dead for quite some time. The more recent repeal efforts represent the hopeless, zombie-like staggering of the GOP towards its goal of almost a decade.

It has been obvious for months that the repeal effort was doomed to failure. As soon as the dust settled from the election, we knew that the GOP would have less than the 60-vote majority required for cloture on a full repeal of the ACA.

With “repeal-and-replace” out the window, Republican leaders shifted to a reform model. The effort immediately drew fire from both wings of the Republican Party. A quartet of moderates from Medicaid expansion states lined up to oppose anything that threatened the Medicaid payouts. With only a two-vote majority in the Senate, this would have been enough to kill the reform bill, but conservatives also lined up to oppose the bill because it fell short of full repeal, which was already a mathematical impossibility.

Conservatives such as Ted Cruz (R-Texas) and Mike Lee (R-Utah) were eventually won over to support the compromise reform effort. Moderates Rob Portman (R-Ohio) and Corey Gardner (R-Col.) also dropped their opposition to the bill.

The Republican “nays” who joined every Democrat in voting against the Skinny Repeal were two of the usual suspects, Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine). The third was GOP maverick John McCain (R-Ariz.) who explained his vote against the “shell of a bill” by arguing in a statement  that the bill, written in secret, wouldn’t actually improve the health insurance crisis gripping much of the country.

McCain will be pilloried for his vote, but to some extent he was right. No one, not even those who voted for it, think Skinny Repeal was a good bill. As Phillip Klein of the Washington Examiner described, the bill left the regulatory framework of Obamacare in place while eliminating the individual mandate. The result would most likely have been to increase the Obamacare death spiral rather than fixing it.
The worst part is that Collins and Murkowski could not even be persuaded to join their colleagues in such a watered-down bill. One has to wonder exactly what kind of health care bill, if any, that the pair would give their assent to.
Throughout the entire process, President Trump, a man who has repeatedly said that he wants universal healthcare, has been mostly AWOL. While Congress debated and dithered, the president spent his time tweeting and hurling insults at Jeff Sessions. To the surprise of few, this approach failed to swing votes to support the bill. In spite of the president’s alleged prowess at deal-making, his main role in the legislative process was to threaten to support a primary challenge against Nevada senator, Dean Heller.
At this point, Republicans have two choices. The first is to offer some concessions to Democrats to craft a bill with broader support. Such tactics will fall short of full repeal, but may help to fix at least some of Obamacare’s problems. It might even convince Collins and Murkowski to vote “yes.” Who knows?
The other alternative is to harden the party’s divisions with another of the circular firing squads so common in the wake of GOP defeats (and victories as well, for that matter). That will mean that Obamacare remains fully intact while Republicans wait on voters to grant them a supermajority (plus two more to offset Collins and Murkowski). In the meantime, Americans will suffer under Obamacare’s high premiums, few choices and the individual mandate. Never mind that voters are unlikely to give Republicans more power if they can’t get anything done with the power that they already have.
Some will say that Democrats win when Republicans offer a compromise, but it is the second scenario where Democrats really win. Obamacare will remain in place for the foreseeable future and Barack Obama’s legacy will be secure.
What most voters really want is for the two parties to work together to solve problems. Unfortunately, the current model has the country lurching from one-party rule to stalemate and back again as each party plays to its base and ignores moderates and independents. If neither party is willing to work with the other to get things done for the good of the country, then voters should consider firing them both.

Cruz-Lee Provision Is Reportedly In New Health Bill Draft

As Republicans scramble to find enough Senate votes to keep their health care reform effort alive, there are reports that the most current draft of the bill will contain a provision written by Mike Lee (R-Utah) and Ted Cruz (R-Texas) that is popular with conservatives. Axios cites three sources familiar with the bill who say that the proposal of the two conservatives to allow a liberalization of health policy requirements is part of the bill at least for the time being.

Under the Consumer Freedom Protection option, health insurance companies that sell policies that are compliant with the requirements of the Affordable Care Act will be allowed to sell noncompliant policies as well. The ability to buy noncompliant policies should help consumers find lower cost health insurance.

The ACA mandates “essential health benefits” that must be included in health insurance policies. These requirements often include coverages that consumers may not want, need or can afford. The requirement to provide these coverages in all plans drives up costs and puts insurance out of reach for many consumers.

Critics of the provision say that healthy consumers will choose the lower cost noncompliant plans while those who are sick will likely buy the more expensive compliant plans. They argue that this will contribute to the death cycle of Obamacare and raise the cost of insurance for people with pre-existing conditions. These costs would be passed along to the federal government through insurance subsidies.

Over the past few months, the GOP reform effort has been losing support from both the center and the right. Republican moderates oppose the bill because of its phase out of the Medicaid expansion while conservatives argue that the bill does not go far enough in repealing and replacing Obamacare. Inclusion of the Cruz-Lee provision may have the effect of winning back the votes of some members of the conservative wing of the party.

The Axios report also gives several other details about the current version of the bill. The new version increases the amount of money for states to stabilize their health markets and cover pre-existing condition to more than $170 billion. It also keeps two of the Obamacare tax increases on wealthy families. Other new provisions allow consumers to pay insurance premiums with money from health savings accounts that receives favorable tax treatment and allow people receiving ACA insurance subsidies to buy lower cost insurance policies that provide only catastrophic coverage.

The laws of supply and demand dictate that as prices fall, demand will increase as more people can afford the product. As the price of health insurance decreases, more people will decide that insurance protection is worth the cost.

Republicans had planned to vote on the bill before the Independence Day recess, but delayed the vote due to opposition from Republican senators. Majority Leader Mitch McConnell (R-Ky.) said that he hopes to bring the bill to a vote next week.

Republican Senators Say Health Bill is Dead

John McCain (R-Ariz.) and other Republican senators are saying what everybody seems to already know about the Republican repeal/reform-and-replace effort. After eight years of campaigning to repeal Obamacare, it increasingly seems that the Republican effort is about to die within sight of its goal.

“I think my view is it’s probably going to be dead,” McCain said on “Face The Nation,” adding, “but I am- I’ve been wrong.”

McCain said that if the current bill fails, Republicans should try again with a bill that aims to win some Democrat votes. “Introduce a bill,” McCain said. “Say to the Democrats, ‘Here’s a bill.’ It doesn’t mean they control it. It means they can have amendments considered. And even when they lose, then they’re part of the process. That’s what democracy is supposed to be all about.”

The close margins in the Senate, 52 Republicans to 48 Democrats, mean that, unless some Democrats cross the aisle to vote for the Republican bill, the GOP can only lose two votes and still be able to pass the bill. The GOP health plan has come under fire from moderates like Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) as well as from conservatives like Ted Cruz (R-Texas) and Mike Lee (R-Utah).

Senator Bill Cassidy (R-La.) agreed with McCain’s assessment on “Fox News Sunday.” “Clearly, the draft plan is dead,” Cassidy said, “but we don’t know what’s in the serious rewrite” of the bill.

Even Senate Majority Leader Mitch McConnell (R-Ky.) admitted the bleak future of the bill. McConnell said that, while he isn’t giving up on repeal, Republicans may need to work with Democrats on a short-term fix for Obamacare.

President Trump and other Republicans from Ben Sasse (R-Neb.) to Rand Paul (R-Ky.) have called upon congressional Republicans to simply repeal Obamacare if they cannot agree on a replacement. A repeal bill would face the additional hurdle of a cloture vote that would require 60 votes for passage.

Sasse suggests a new version of the 2015 Obamacare reconciliation bill. Unless Collins, Murkowski and other GOP holdouts on the Medicaid expansion reverse themselves, this bill would also fall short of even a simple majority.

Without a change of heart from either the Republican moderate or conservative wing, the effort to repeal or reform Obamacare seems to be reaching a dead end. While the future of health insurance in America is uncertain, it is certain that the Republican base would view a failure to repeal Obamacare as the betrayal of a core promise.

The failure to reform Obamacare while they have the opportunity, the single most visible goal of the Republican Party for most of the past decade, could rip the party apart.

Sasse, Paul, and Trump Call For Obamacare Repeal Instead of Reform

In statements echoed by President Trump on Twitter, two prominent Republican senators have called for the GOP to skip the health care overhaul and focus on simple repeal of Obamacare if Republican Senate leadership cannot find 50 votes to move the current health care reform bill forward. Earlier this week, Majority Leader Mitch McConnell (R-Ky.) announced that a vote on the health care bill would be delayed until after the July 4 recess.

In a letter to the White House quoted in the Wall Street Journal, Sen. Ben Sasse (R-Neb.) said, “On the current path it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that looks to prop up many of the crumbling Obama care structures.”

“We must keep our word,” Sasse continued. “Therefore, if on July 10 we don’t have agreement on a combined repeal and replace plan, we should immediately vote again on… the December 2015 Obamacare repeal legislation that the Congress passed but President Obama vetoed.”

Within a few minutes of Sen. Sasse’s discussion of re-introducing the 2015 bill, HR 3762, President Trump tweeted support for the idea. “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” Trump said on Twitter.

Sen. Rand Paul (R-Ky.) also endorsed the idea. “I have spoken to @realDonaldTrump & Senate leadership about this and agree. Let’s keep our word to repeal then work on replacing right away,” Paul tweeted.

The 2015 bill in question, HR 3762, was not technically a full repeal of Obamacare either since it also amended the Affordable Care Act rather than repealing it outright. A full repeal would require 60 votes for cloture in the Senate, which is far out of reach. The bill passed the Senate in a largely party line vote on December 3, 2015 by a 52-47 margin.

Sasse has not suggested a strategy for passing a 2017 version of the bill. The problem for Republicans on passage of the current health care reform bill is that nine Republican senators are reportedly in opposition to the bill. Assuming no Democrats cross the aisle, Republicans could lose no more than two senators and still be able to pass the bill.

The current Republican opposition to the health care reform is from both the center and the right wings of the GOP. Moderate Republicans such as Susan Collins (R-Maine) and Rob Portman (R-Ohio) argue that the bill hurts too many people on Medicaid in their states while conservatives such as Ted Cruz (R-Texas) and Mike Lee (R-Utah) say that the bill does not go far enough in reforming Obamacare. With eroding support from both ends of Republican political spectrum, the current bill has little chance of passage.

Sasse’s plan to revive the 2015 bill is a partial answer in that it should bring the conservatives back on board. The problem is that Republicans would still need moderate votes to move the bill forward.

When the bill originally passed in 2015, Republicans held two more seats in the Senate than they do today. Back then, two Republicans crossed party lines to vote against the bill: Susan Collins and Mark Kirk (R-Ill.). Kirk lost his seat to Democrat Tammy Duckworth in 2016, but Collins is still in the Senate and could be counted on to vote against the bill once again. That leaves Republicans with a one vote margin.

Earlier this year, The Resurgent reported that four Republican senators who had voted for the 2015 bill would refuse to vote for a bill that did not allow a slow phase out of the Obamacare Medicaid expansion. If Shelly Moore-Capito (R-W.V.), Rob Portman (R-Ohio), Corey Gardner (R-Col.) and Lisa Murkowski (R-Alaska) stick to their pledge, it would doom Sasse’s plan.

Still, a deficit of five votes is a more surmountable obstacle than the deficit of nine votes that the GOP currently faces. It is possible that pressure could be brought to bear on the four senators who previously voted for the bill that would keep them in the “yes” column.

An additional risk would be with the reform that still must come after the passage of the near-repeal. Democrats might be persuaded to join the reform effort if most of Obamacare was gutted, but they might also adopt a you-break-it-you-bought-it policy that would allow them to campaign against the Republican-created chaos in the health care markets in 2018 and beyond. Given recent Democrat obstructionism, there is little doubt which course they would take.

Still, as the Republican health care reform seems increasingly dead in the water, Sasse’s plan, long shot that it is, may be the only viable option to keep the GOP promise to repeal and replace Obamacare.