In the wake of Republicans’ failure to muster the votes for any bill to repeal the Affordable Care Act, the Trump administration and Capitol Hill lawmakers are moving in opposite directions, with no cohesive strategy for the months ahead.
The White House responded to the back-to-back-to-back defeat of three separate Republican health care bills by demanding Congress try again, ordering lawmakers to put all other business on hold until Obamacare is repealed. (They have not complied. A vote to confirm a judge to the 11th Circuit is scheduled for Monday evening.)
The president met Friday with a handful of Senate and House Republicans pushing yet another Republican-only proposal to undo parts of the ACA. But without a score from the Congressional Budget Office and no sign of buy-in from the Republican defectors who tanked the other repeal bills, the still-unwritten bill appears headed for the same fate as its predecessors.
Trump’s other strategy has been—once again—to threaten to cut off cost sharing reduction payments (CSRs) to health insurance companies, a move that would throw the individual market into chaos and trigger massive hikes in premiums. Trump has openly mused that this will bring Democrats and holdout Republicans to the table on an Obamacare repeal effort, but so far it has only pushed lawmakers across the political spectrum to warn that cutting off the payments would hurt sick and low-income Americans and Republicans would pay a huge political price for the sabotage.
Overall, Congress appears to be largely unmoved by the ham-handed threats and demands coming from the other end of Pennsylvania Avenue. Instead of complying with Trump, lawmakers are moving in the opposite direction, working across the aisle on plans to stabilize the individual market.
Senate Minority Leader Chuck Schumer (D-NY) said Monday that 10 Republicans have reached out to him, interested in crafting a bipartisan solution.
Over in the House, a group of 40 representatives who call themselves the Problem Solvers Caucus announced Monday a plan to appropriate the CSR payments to insurers and create an additional federal stability fund that states can use to lower the out-of-pocket costs for people with the most severe medical needs. The plan also includes repealing some of Obamacare’s taxes, allowing small companies to drop their employees’ health insurance, and giving states the ability to waive some regulations.
Neither House Speaker Paul Ryan (R-WI) nor Senate Majority Leader Mitch McConnell (R-KY) have signaled, however, any interest in such an approach. McConnell issued a curt statement just hours after the failed repeal vote, saying: “Bailing out insurance companies with no thought of any kind of reform is not something I want to be part of.”