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.”