GOP lawmakers, Trump at odds over insurance payments


http://thehill.com/policy/healthcare/344700-gop-lawmakers-trump-at-odds-over-insurance-payments?utm_source=&utm_medium=email&utm_campaign=10102

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Lawmakers are facing off with President Trump over key ObamaCare payments that are in jeopardy after the collapse of efforts to repeal the healthcare law.

Trump is threatening to cancel the payments, known as cost-sharing reductions (CSRs), as part of his effort to make ObamaCare “implode.”

But he is running into opposition from key Republicans, including Senate Finance Committee Chairman Orrin Hatch (Utah) and House Ways and Means Committee Chairman Kevin Brady (Texas), who say they want to find a way to guarantee the payments, which reimburse insurers for giving discounted deductibles to low-income ObamaCare enrollees.

If the payments were cancelled, insurers have warned they would either have to spike premiums to make up for the lost money, or drop out of the market altogether, limiting people’s options for coverage.

Trump could announce that he is cancelling the payments as early as Tuesday.

Rep. Chris Collins (R-N.Y.), one of Trump’s top supporters on Capitol Hill, told CNN on Monday that he had encouraged Trump to announce the cancellation on Tuesday.

Trump has long warned that he could cancel the payments, though it is unclear if he will follow through.

In addition to a premium spike that experts estimate could reach 20 percent, Democrats warn that there would be a political fallout as well if people blame Trump for the chaos.

A Kaiser Family Foundation poll in May found that 63 percent of the public thinks Trump and congressional Republicans are responsible for problems with the Affordable Care Act going forward.

Senate Democratic Leader Chuck Schumer (N.Y.) on Monday said there would be a “Trump tax” on people’s premiums if he cancelled the payments.

Trump seemed to refer to cancelling CSRs on Saturday when he tweeted: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!”

Trump has alternated between saying he will simply cause ObamaCare to implode and calling for Congress to repeal the law.

In another tweet on Saturday, Trump called for Congress not to give up on repeal and to vote on it before acting on any other bill.

Many congressional Republicans have called for continuing the CSR payments.

In a statement Friday, Brady warned that “simply letting Obamacare collapse” would cause “even more pain” for people in his district facing high premiums and fewer choices.

“For those trapped in Obamacare, we must continue to look for immediate solutions to deliver relief, stop premiums from soaring even higher, and help people get the health care that’s right for them,” Brady said.

Hatch told Reuters in an interview Monday that he did not want to provide funding for the CSRs, but “I think we’re going to have to do that.”

Sen. Lamar Alexander (R-Tenn.), chairman of the Senate health committee, has also called for Congress to act on the payments. His committee will be holding hearings on improving the stability of the ObamaCare markets in the near future, which could lead to bipartisan action.

“I guess I’m hopeful that the administration, the president will keep making them and if he doesn’t then I guess we’ll have to figure out from a congressional standpoint what we do,” Sen. John Thune (R-S.D.), the No. 3 Senate Republican, said on Monday.

Sen. John Cornyn (R-Texas), the No. 2 Republican, noted that Trump would have to sign legislation guaranteeing the payments, making it a “challenge.” He also said that the prospect of action by Congress is a “real live issue.”

A House GOP aide said Monday that Republicans are still looking at different legislative vehicles for temporarily guaranteeing the CSR payments.

Democrats are pushing for Congress to guarantee the payments soon, to reduce uncertainty for insurers ahead of an Aug. 16 deadline for filing their premium rates for next year.

In more momentum for congressional action, a bipartisan group of more than 40 House lawmakers on Monday unveiled a proposal to fix problems with ObamaCare, including guaranteeing funding for the CSRs, which would take the issue out of Trump’s hands.

“Cutting off those payments further destabilizes the individual market and these are real people,” Rep. Tom Reed (R-N.Y.), one of the leaders of the bipartisan effort in the House, told The Hill on Monday.

Reed said that while he still supports repeal of the health law, Republicans should try a different, bipartisan, direction rather than “engage in insanity by doing the same thing over and over again.”

Still, there are other Republicans who are still pressing to repeal and replace ObamaCare.

Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) have both attended meetings at the White House in recent days focused on trying to revive such legislation.

The two senators have written a measure that would convert current ObamaCare spending into a block grant given to states, which is aimed at giving states flexibility. Democrats warn the block grants would be significantly less than current spending levels, leading to cuts.

The proposal faces a steep path to passage, especially given that McConnell indicated he is moving on from repeal efforts for now.

Reed said that he had kept House GOP leaders apprised of the bipartisan group’s work.

“I hope so,” Reed said when asked if leadership is open to bipartisan action on healthcare. “The other path is not working.”

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