President Donald Trump said he’s supportive of the work lawmakers are doing to help temporarily stabilize the Affordable Care Act public exchange system, as a bill to do so was introduced Thursday with broad bipartisan support in the Senate.
“I respect very much the two senators your talking about, I love that they’re working on it,” Trump said at the White House Thursday when asked about his position on the bill.
Shortly after Trump’s comments, Tennessee Republican Lamar Alexander and Washington Democrat Patty Murray introduced their stabilization bill with 22 senators, half of whom are Republicans. That broad backing could give the package momentum in the Senate.
“This is a first step,” Alexander said on the Senate floor. “Improve it and pass it sooner rather than later.”
Time is short for lawmakers to act before Nov. 1, when the public exchange system opens for Americans to sign up for coverage. Even if a bill passes, it’s likely to be a chaotic enrollment season. Health insurers have sharply raised the rates they plan to charge next year, citing the uncertainty in Washington. And Trump, who’s sent contradictory signals about the bipartisan bill in the past days, has said he’s taking steps to dismantle Obamacare and wants to eventually replace it.
The legislation will also have to make it through the House, where Republicans have said they too want to repeal Obamacare, not stabilize it.
Trump said that’s ultimately his priority as well, and he prefers giving money to states to run their own programs. “It’ll be absolutely short term because ultimately it’s going to be repeal and replace,” he said of the Senate bill.
Trump has made conflicting statements on the Senate effort, urging lawmakers to work on it and then seemingly pulling back his support for it. Alexander said the version he’s introducing contains language to make clear there won’t be what Trump has cast as a bailout of health insurers.
“I want them to be careful with respect to the insurance companies, insurance companies are extremely good at making money,” Trump said. “I want to take care of our people. I don’t want to take care of our insurance companies.”
The bill has “about a page and a half of language in our agreement that tries to make it clear that the benefits of cost-sharing reductions go to consumers and not insurance companies,” Alexander said in an interview Thursday before the bill was introduced.
The bill would pay for two years of health insurance subsidies, known as cost-sharing reduction payments, that were instituted under the Affordable Care Act and help consumers afford out-of-pocket health costs. Trump cut off those payments last week, leaving it up to Congress to fund them. The bill would also give more flexibility to states to modify how the Affordable Care Act is run in their own public exchange programs.
“Some have said well that’s not enough,” Alexander said. “Well, that’s more than we’ve gotten for eight years and it’s a first step.”
The bill requires states to come up with their own plan to ensure that insurers that have already set 2018 premiums higher given uncertainty over the payments don’t get to double dip. The state plans could include monthly or one-time rebates to consumers or the federal government. It’s unclear whether this will appease Trump. Senate Majority Whip John Cornyn of Texas said the president has to be comfortable with the measure before it can come to the Senate floor for a vote.
The legislation also gives states flexibility to implement the Affordable Care Act and allows anyone to enroll in catastrophic plans that cost less up front.
On the Republican side, co-sponsors of Alexander’s bill include three senators who have opposed previous efforts by the GOP to repeal and replace the Affordable Care Act: John McCain of Arizona, Susan Collins of Maine and Lisa Murkowski of Alaska.
Murkowski thanked Alexander and Murray for helping the Senate find a “better path.”
Others such as Sen. Ted Cruz, a Republican from Texas, shared Trump’s concerns. He tweeted Wednesday that “Ins co profits have DOUBLED under O’care & Dems top priority is corp bailouts w/ nothing for citizens paying higher premiums.”
Alexander predicted the bill would become law this year.
“I do not believe that Congress would want to fail to deal with a problem that will hurt millions of Americans if we allow it to continue,” he said. “I predict that this agreement that we’re suggesting today, we 24 senators, will become law in some fashion before the end of the year.”
—With assistance from Steven T. Dennis, Arit John, James Rowley and Zachary Tracer.
—-Read Trump Praises Deal to Trade Temporary ACA Cash for State Flexibility on ThinkAdvisor.