Tuesday, October 17, 2017

Trump has mixed messages on Obamacare subsidies deal; McConnell is noncommittal, and some in GOP oppose it

UPDATE, Oct. 18: White House Press Secretary Sarah Huckabee Sanders said Wednesday that President Trump is opposed to the deal as it now stands. Sen. Lamar Alexander said he expected the deal to become law by the end of the year.

"A pair of leading Republican and Democratic senators reached an agreement Tuesday to fund key federal health-care subsidies that President Trump ended last week — and the president expressed support for the plan," The Washington Post reports. But it remains to be seen whether Majority Leader Mitch McConnell, other Republican Senate leaders, and leaders of the House's Republican majority, would go along.

“We haven’t had a chance to think about the way forward yet,” McConnell said at his weekly news conference, "minutes after the deal was announced about 20 feet away outside a Republican policy luncheon," Sean Sullivan and Juliet Eilperin report for the Post.

Just last week, Trump cut off the subsidies, which reimburse insurance companies for reducing out-of-pocket costs such as co-payments and deductibles for lower- and moderate-income Obamacare policyholders. Tuesday, he said of the deal, “It’ll get us over this intermediate hump,” and called it “a short-term solution so that we don’t have this very dangerous little period.”

Insurers have said that without the subsidies, "premiums for many customers purchasing plans under the Affordable Care Act would shoot up, and with profits squeezed, some of the companies would probably leave the market," The New York Times reports. That could leave some counties, especially in rural areas, without any Obamacare insurers.

The deal between Sens. Lamar Alexander of Tennessee and Patty Murray of Washington, the Republican chairman and ranking Democrat of the Senate health committee, would give states more flexibility in Obamacare. For example, Alexander "said the proposal would offer states greater freedom by allowing them to make changes to insurance offerings as long as the plans had 'comparable affordability,' which is a slightly looser definition than the existing one."

"For Democrats, not only would the cost-sharing reductions be brought back, but millions of dollars would be restored for advertising and outreach activities that publicize insurance options available in the health law’s open enrollment period, which starts next month," the Times reports. "The Trump administration had slashed that funding."

“We will spend about twice as much or more than President Trump wanted to expend,” Alexander said. “This agreement avoids chaos, and I don’t know a Democrat or a Republican who benefits from chaos.”

But the path forward remained unclear. The House is in recess week, and a spokesman for Speaker Paul Ryan declined to comment, but some leading House conservatives objected to the plan, and Rep. Tom Cole (R-Okla.), a close ally of House GOP leaders, told the Post, “None of our guys voted for Obamacare. They’re not very interested in sustaining it.” UPDATE, Oct. 18: House Speaker Paul Ryan, "reflecting his most conservative members, came out against the deal on Wednesday," the Times reports.

Across the Capitol, "Many Republican senators are distancing themselves" from it, the Post reports. However, Thomas Kaplan and Robert Pear of the Times report: "Sen. John Thune of South Dakota, a member of the Senate Republican leadership, said there would be 'a sense of urgency to move a bill,' since Mr. Trump intended to stop the payments right away."

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