- The Washington Times - Tuesday, November 13, 2018

Sen. Joe Manchin III, a West Virginia Democrat who just won re-election in one of the country’s reddest states, has an idea to fix Obamacare — call in President Trump.

The West Virginian is among senators on both sides of the aisle who want to bring back a bipartisan “reinsurance” plan, in which federal dollars blunt the costs of pricey customers in states’ markets, so everyone else can pay less.

A similar plan fell apart earlier this year, as both sides girded for a bitter midterm-election campaign. Yet Democrats romped to victory in the House and limited their Senate losses in a very unfavorable map, leaving a divided government and a chance for the White House to step in and find common ground.

“It’s going to be called ‘Trump Repair-care,’” Mr. Manchin said. “It really should be, because he’s the only one who can fix it. And I’m hoping he does.”

Sen. Bill Cassidy, Louisiana Republican, said lawmakers are already reaching for consensus on health costs, citing efforts to tamp down surprise medical bills and rein in drug prices by forbidding “gag clauses” at the pharmacy counter.

Like Mr. Manchin, he’s hopeful that bipartisan negotiators can revive a deal that stabilizes the Obamacare markets, after Democrats walked from the initial plan over anti-abortion language.

“I think they wanted an issue, and hopefully now they want a solution,” Mr. Cassidy said.

The reach for consensus is a far cry from two years ago, when Republicans toasted its 2016 victories by vowing to make good on their pledge to repeal and replace Obamacare. The process was a tortured one, as a bill squeaked through the House but fell apart on the Senate side amid three GOP defections.

Republicans never fully recovered. They lost more than 30 House seats last week and a Senate seat in Arizona, where Democrat Kyrsten Sinema forced Republican opponent — Rep. Martha McSally — to defend her votes for Obamacare repeal amid swirling debate over protections for people with pre-existing conditions.

“We did a horrible job replacing, and did a horrible job messaging as well,” said Sen. Ron Johnson, Wisconsin Republican.

Health care was the number-one issue for voters, according to exit polling, and three ruby-red states opted to expand Medicaid — a key plan of Obamacare — through ballot measures.

“They voted for a check on President Trump and a Congress that would stop trying to take away their health care,” Senate Minority Leader Charles E. Schumer said Tuesday, in his first post-election floor speech. “After two long years, that’s what they’ll get. Republican plans to rip health care away from Americans have been stymied.”

A senior Democratic aide said the new majority will swiftly hold a vote in support of protections for pre-existing conditions that “still under legal assault by the GOP.”

The measure would allow the House to intervene in a Texas lawsuit that argues Republican tweaks to the 2010 law rendered the rest of the program unlawful — including protections for people with preexisting conditions.

Another Democratic idea is to bolster federal help for people who buy insurance on their own but struggle to afford Obamacare’s offerings.

Earlier this year, senior Democrats on key committees — Reps. Frank Pallone, Richard Neal and Bobby Scott — cosponsored a bill that would make subsidies available to higher earners and beef up the tax credits for all income groups. It would also restore Obamacare outreach funds that Mr. Trump canceled and fund a federal reinsurance program.

“The Pallone-Neal-Scott bill is a great starting point to lowering health care costs,” said C.J. Young, a spokesman for Democrats on the House Energy and Commerce Committee. “We will be looking at the bill as a framework for where we want to go next year.”

Bolder ideas, like a public option to compete with private plans, is unlikely to proceed while Republicans control the Senate and White House, though the idea won’t go away completely.

“I think it will get lots of discussion,” Sen. Tammy Baldwin, Wisconsin Democrat who cosponsored Sen. Bernard Sanders’ bill to establish a single-payer, “Medicare for all” system.

Zach Hunter, a spokesman for Rep. Greg Walden, Oregon Republican who will lead the committee through the end of the year, said the GOP will come to the table on “patient centered” solutions while in the minority, but not government-centered ones like a public option.

Indeed, the Republican approach will likely tack along two prongs — renewing their push for the workable, market-oriented plan that eluded them last year, while playing defense against a full government takeover of the health system, said Sally Pipes, president and CEO of the Pacific Research Institute.

“I think the Republicans need to come up with a plan that will bring about market-driven health care. If they had a better plan in 2017, they might have been able to repeal and replace and been able to get together [on it],” she said. “The second thing is fight Medicare for all.”

House Majority Leader Kevin McCarthy says the GOP will need to provide alternatives to single-payer plans that would upend employer-based insurance that many Americans enjoy.

“It would break the system that we currently have,” he said on Fox’s “Sunday Morning Futures” program. “That is why it’s important that Republicans continue to put forth their ideas, their ideas to make health care a better quality at a lower price, that we continue to do this on a time-and-time-again basis.”

The Texas lawsuit remains the wild card in Congress’ emerging plans.

In September, U.S. District Court Judge Reed O’Connor appeared to side with plaintiffs who felt Congress’ decision to zero out the “individual mandate” penalty for shirking insurance meant the law’s goodies should go away, too.

Any day now, the judge will decide whether to issue a preliminary injunction that stops Obamacare in its tracks — a move that would force Congress to mull fixes.

Experts say the lawsuit would remain a long shot on appeal, however, leaving Mr. Trump to nibble around the edges of the law’s mandates and coverage rules.

The election results didn’t appear to deter Mr. Trump from using his executive authority to satisfy his conservative base on health care.

Less than 24 hours after the results came in, he delighted pro-life supporters by requiring separate bills for abortion coverage under Obamacare and finalizing rules that allow a wide range of closely-held businesses and religious nonprofits to claim a religious or moral exemption from insuring birth control in their health plans.

Sen. Patty Murray, Washington Democrat, said Mr. Trump appeared to take the wrong lesson from Election Day.

“A day after people across the country rejected the Trump-Pence agenda of undermining women’s health care and rights,” she said, “President Trump chose to steamroll right over the will of the people and double down on his harmful policies.”

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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