- The Washington Times - Monday, October 23, 2017

Senate Minority Leader Charles E. Schumer begged President Trump Monday to endorse a bipartisan deal to stabilize Obamacare’s markets, saying the bill “has the necessary 60 votes” to pass without hiccups after every Democrat and a dozen Senate Republicans rallied to it.

“That’s as bipartisan as it gets,” Mr. Schumer, New York Democrat, said.

Mr. Trump has flip-flopped on his support for the legislation and is making demands that would pull the deal to the right, upsetting Democrats and making it more difficult for Republican sponsors to turn their negotiations into a finished product.

As written, the deal by Sens. Lamar Alexander, Tennessee Republican, and Patty Murray, Washington Democrat, would approve payments in 2018 and 2019 for what’s known as “cost-sharing reductions” — federal money sent to insurers to reimburse them for covering out-of-pocket health care costs of lower-income Americans.

Mr. Trump recently said he can no longer legally make the payments on his own, prompting fears of higher premiums and ratcheting up pressure on Congress to act.

Republicans, in return, would get long-sought flexibility for states to reshape their markets and expand the sale of bare-bones “copper plans” to all ages, so healthier people have more options.

A dozen senators from each party announced their support for the legislation last week, though Mr. Schumer says all 48 Democrats will back it.

“Mr. President, come out and support the Alexander-Murray bill,” Mr. Schumer said. “You’ve called it, quote, a ‘very good solution’ already.”

Yet Senate Majority Leader Mitch McConnell said Sunday he will wait for Mr. Trump’s approval before he puts it on the floor.

The White House says it likes the idea of a bipartisan package, but the deal isn’t strong enough to win Mr. Trump’s support just yet, particularly as the House GOP dismisses it as a “bailout” for insurers that doesn’t offer enough state flexibility or relief from Obamacare’s rules in return.

The administration is circulating a one-page list of “principles” it wants to include in any short-term bill to “provide relief to Americans suffering under Obamacare.”

It includes waiving penalties under the individual mandate to hold insurance for the 2017 tax year, and fines tied to the employer mandate requiring firms with 50 or more full-time workers to provide adequate coverage.

The White House wants to raise the limit on contributions to health savings accounts and let consumers use the tax-advantaged accounts to pay for premiums and direct costs from checkups with their primary doctors.

It also wants to expand access to “association plans” that allow people in trade groups and workers in similar lines of work to band together and buy coverage.

Earlier this month, Mr. Trump ordered agencies to explore ways to let people buy these plans across state lines, without having to comport with Obamacare’s coverage requirements. Critics said the move could siphon healthy customers out the markets.

Mr. Alexander characterized the White House’s demands as part of a natural give-and-take, as congressional Republicans work with the administration to stamp out fires in the insurance markets before settling on a long-term plan to repeal and replace Obamacare next year.

“This is the normal legislative process with people of different views saying what they are for and against,” Mr. Alexander said. “Something close to the Alexander-Murray proposal is likely to become law this year because the president himself asked us to develop this short-term solution so people aren’t hurt by a chaotic insurance market, a bipartisan group of 24 senators is sponsoring our bill, it gives states new power to create choices and lower prices, and House Republicans have already voted once this year for continuing cost sharing provisions for two years.”

Conservatives say it will be difficult for them to cast votes that stabilize Obamacare without a clear path to repeal, though Mr. Alexander said they have to act in the meantime, since GOP plans wouldn’t kick in until 2020, anyway.

He cited Iowa’s decision Monday to withdraw a waiver, known as a “1332,” that would have reshaped its health market by offering subsidies to higher-earners and blunting the cost of expensive customers.

State officials said they couldn’t get around Obamacare’s strictures.

“Iowa’s decision is further evidence that the Affordable Care Act is too restrictive to allow states to help people who need to buy insurance. The so-called guardrails have become roadblocks,” Mr. Alexander said.

Democrats say they are willing to strengthen part of the deal that prevents insurers from “double dipping” into both cost-sharing payments and higher-than-normal premiums.

However, any changes that unravel Obamacare’s core provisions would likely upend the deal. For instance, insurers view the individual mandate as a critical spur to get healthy people into the markets, and might quit the program if it is softened.

Democrats are trying shift blame for rising premiums from the law itself to Mr. Trump’s “sabotage,” from slashing program outreach to declaring the payments invalid on the cusp of open enrollment.

Unless one side gives, the issue could fester until Congress decides to attach the effort to a must-pass bill, such as a spending bill to avoid a government shutdown in December.

Mr. Schumer taunted the president from the Senate floor Monday, saying he is “not showing much leadership” when the “hard right” rebuffs him on issues.

“Maybe it’s cause he doesn’t want a bipartisan bill. Maybe it’s cause he wasn’t involved,” Mr. Schumer said, later adding: “It’s time, Mr. President, to turn the page on health care and pass Alexander-Murray.”

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