WASHINGTON — The authors of a bipartisan plan to calm health insurance markets said Wednesday they’ll push the proposal forward, even as President Donald Trump’s stance ricocheted from supportive to disdainful to arm’s-length and the plan’s fate teetered.
“If something can happen, that’s fine,” Trump told reporters at the White House. “But I won’t do anything to enrich the insurance companies because right now the insurance companies are being enriched. They’ve been enriched by Obamacare like nothing anybody has ever seen before.”
The agreement by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on a two-year extension of the federal subsidies to insurers that Trump has blocked gained an important new foe on Wednesday. The anti-abortion National Right to Life said it opposed the measure because it lacked language barring people from using their federally subsidized coverage to buy policies covering abortion, said Jennifer Popik, the group’s top lobbyist.
In another blow, Doug Andres, spokesman for House Speaker Paul Ryan, R-Wis., said Ryan “does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare.” With hard-right conservatives wielding considerable influence among House Republicans, it was unclear if Ryan would be willing to even bring the measure to his chamber’s floor.
Alexander and Murray shook hands on their agreement this week after months of intermittent talks. Failure to restore the federal payments to insurers could result in higher premiums for millions buying their own individual policies and drive carriers from unprofitable markets. Many in Congress would love to avoid blame for two such tumultuous events.
The compromise has won warm endorsements from Democrats and some Republicans. It includes steps won by Republicans to make it easier for insurers to avoid some coverage requirements under President Barack Obama’s Affordable Care Act.
But Trump has lambasted the subsidies as insurance company bailouts. Other GOP lawmakers are loathe to prop up Obama’s statute, a law they’ve long vowed to repeal.
“I think right now it’s stalled out,” No. 3 Senate GOP leader John Thune of South Dakota told reporters.
The money reimburses carriers for lowering co-payments and deductibles for about 6 million lower-income customers, which the companies must do under Obama’s statute.
Without those funds, insurers would likely boost premiums by an average 20 percent, the nonpartisan Congressional Budget Office has projected. This would especially hit many buying their own health insurance who earn too much to qualify for tax credits that help lower earners reduce their premiums.
Confusingly, Trump praised the bipartisan agreement early Tuesday as a “very good solution,” only to berate it in an evening speech. Some said his objections Wednesday to enriching insurers could be addressed by strengthening language in the compromise to ensure the money directly benefits customers, not companies.
“We will keep working on it,” said Alexander. He said he and Murray would formally unveil the bill on the Senate floor Thursday and predicted that “some form of the proposal” would become law by year’s end.
“The president has had six positions on our bill,” Murray told reporters. Asked if the measure was still alive, she said “of course it is.”
Alexander said Trump called him Wednesday morning and encouraged him to continue his effort, but left himself wiggle room.
“I may want to add something to it,” Alexander said in a brief interview with The Associated Press, describing what Trump told him about the deal. “And it may have to be part of a larger negotiation.”
Even so, the plan’s prospects remained shaky.
Senate Finance Committee Chairman Orrin Hatch, R-Utah, said: “It would last two years and spend a whopping amount of money and not solve the problem and lead us down a path of never getting the problem done.” Senate Majority Leader Mitch McConnell, R-Ky., has been non-committal about the plan.
Senate Minority Leader Chuck Schumer, D-N.Y., said that to address Trump’s aversion to enriching insurers, Democrats had offered to delay the measure’s impact for a month after enactment to give insurers a chance to lower premiums once the subsidies were restored. Insurers in some states have installed higher premiums for next year, anticipating the subsidies would end. Schumer said White House officials rejected that idea.
Schumer said Trump’s support would be crucial.
“If the president will come out strongly for the bill and stick to that, that will help in getting it through the House,” he said.
GOP co-sponsors so far include Sens. John McCain of Arizona, Lisa Murkowski of Alaska and Tennessee’s Bob Corker. Alexander hopes to have more than that when he presents the measure Thursday, matched by an equal number of Democrats.
Also backing the measure is America’s Health Insurance Plans. The giant trade group for insurers said the proposal would “provide American consumers with a more stable insurance market, states with more flexibility to meet the needs of their citizens, and more choice and more affordable care.”
