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The Search for Intelligent Bipartisanship on Health Care

Rank-and-file lawmakers to keep pushing the issue

Sens. Susan Collins, R-Maine, and Bill Cassidy, R-La., say their bill could be a path forward on health care. (Tom Williams/CQ Roll Call)
Sens. Susan Collins, R-Maine, and Bill Cassidy, R-La., say their bill could be a path forward on health care. (Tom Williams/CQ Roll Call)


With Republican leaders pausing their quest to overturn the 2010 health care law, rank-and-file lawmakers see an opportunity for outreach behind the scenes on the divisive issue.

GOP Sens. Bill Cassidy of Louisiana and Susan Collins of Maine will keep talking to senators and stakeholders about their bill, the Patient Freedom Act, which they believe is a rare avenue for bipartisan cooperation.

“I like to think the Cassidy-Collins bill is well-positioned as a path forward,” Cassidy said Monday.

Republican leaders for now are moving on to other issues after House Republicans’ failed attempt to fulfill a central campaign promise of repealing and replacing the Affordable Care Act, President Barack Obama’s signature legislative achievement. Their bill was pulled Friday because it did not have enough Republican votes to pass the House.

“We’re going to be living with Obamacare for the foreseeable future,” Speaker Paul D. Ryan said Friday. “I don’t know how long it’s going to take us to replace this law.”

President Donald Trump is “absolutely” willing to work with Democrats to pass legislation in the wake of the failed GOP-crafted health bills, White House Press Secretary Sean Spicer said Monday.

The president and senior White House aides have received phone calls from members on both sides of the aisle to seek some kind of resolution, Spicer said, adding, “I don’t think we’ve seen the end of health care.”

Collins said she spoke with a few  moderate Democrats on Monday about whether they would be willing to sit down and discuss a path forward on health care.

“It seems that they are,” Collins said. “I know that there are some members who would prefer that nothing occurred but that’s not really a responsible approach.”

Collins said she was not sure if or when bipartisan talks would occur, since she is still gauging members’ interest in coming to the table. Other Senate Democrats have said they are willing to work with Republicans on the issue, but with conditions.

“I know many of my colleagues on the other side of the aisle do care deeply about fixing our nation’s health care problems. And we’re ready to do that with them in a bipartisan way,” Senate Minority Leader Charles E. Schumer said on the Senate floor Monday. “But of course, repeal must be taken off the table and the president must stop hurting citizens by undermining the Affordable Care Act.”

Asked about Democrats’ conditions, Cassidy pointed out that his bill gives states the option to keep key Obamacare provisions in place. States would have two other options under their bill: adopt a market-based insurance system or design its own system with help from the federal government.

“I would to like think that we’re not going to get stuck on semantics,” Cassidy said.

Schumer has blasted the Patient Freedom Act as “an empty facade that would create chaos.” But Cassidy and Collins could find common ground with more moderate members of the Democratic caucus.

Virginia Sen. Tim Kaine led a group of Senate Democrats in a letter to GOP leaders to work with them on improving the 2010 law. A Kaine spokesperson said Monday that “his offer still stands to sit down at the table with Republicans and discuss common sense changes.”

Kaine’s colleague from West Virginia, Sen. Joe Manchin III, has said he is willing to work with Cassidy, and suggested that the failure of the House GOP bill could spur bipartisan talks.

“If it goes down, then let’s sit down, because we still have to fix it,” Manchin said on Thursday. “It’s still not right.”

Bill Cassidy’s the only one that reached across the aisle — Bill Cassidy. And I told Bill, I said, ‘Bill, here’s the thing: you want to get four or five Republicans, I’ll get four or five Democrats and we’ll all sit down,’” Manchin said the day before the House pulled the GOP health care measure.

“But we will not sit down until you, your group, says they will not vote to repeal,” Manchin said. “That means you’re sincere about fixing it.”

Manchin said Democrats are aware that the 2010 law has its problems. He pointed to issues in the private insurance market and substantial out-of-pocket costs due to high insurance deductibles.

“Anybody that wants to sit down legitimately and fix it, count me in,” Manchin said.

Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander said he is open to holding a hearing on legislative suggestions to fix the 2010 health care law from Republicans or Democrats.

“I don’t think the House action has changed a thing for me and the urgency of our need to deal with it,” the Tennessee Republican told reporters. “I intend to introduce legislation to try to solve the problem of people who may be without insurance in 2018 and I’m looking for bipartisan suggestions about how we move forward.”

Manchin has not spoken with Cassidy since the House bill was pulled. Cassidy said he has not spoken with other Democrats since then either, noting, “Everybody was just taking a breath over the weekend.”

But Cassidy was heartened by the attention their bill has been getting in the wake of the House bill’s failure. Iowa Republican Sen. Charles E. Grassley, who is not a co-sponsor, tweeted that addressing health care should be bipartisan. He tweeted about the Cassidy-Collins bill, encouraging lawmakers to “CHECK IT OUT.”

Cassidy said he and Collins will continue pushing their bill and looking for improvements. That involves talking to individual senators as well as stakeholders including governors, doctors, leaders of medical schools and consumers.

Cassidy acknowledged that Congress has a tightly packed agenda in coming months that includes a Supreme Court confirmation battle, rolling back more Obama-era regulations, tackling the complicated issue of overhauling the tax code, and funding the government.

“The Senate schedule is crowded,” Cassidy said. But, he said, “there are events in the saddle” that could bring health care back to the forefront.

“Health care has to be addressed,” Cassidy said. “I can’t tell you when it’s going to happen but the individual market, as the president said, is exploding.”

Cassidy said more insurance companies could pull out of the individual marketplaces in the states, and insurance premiums could continue to rise, prompting Congress to act. 

John T. Bennett and Joe Williams contributed to this report.

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