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Senate Pins Health Care Hopes On Bipartisan Bill

Repeal efforts on 2010 law ebb as other measures pop up

Senate HELP Chairman Lamar Alexanderwants to move quickly on legislation to stabilize the health insurance markets, but other attempts to address health care might get in the way. (Bill Clark/CQ Roll Call file photo)
Senate HELP Chairman Lamar Alexanderwants to move quickly on legislation to stabilize the health insurance markets, but other attempts to address health care might get in the way. (Bill Clark/CQ Roll Call file photo)

A last-ditch attempt by Senate Republicans to repeal and replace the 2010 health care law appears unlikely to get off the ground, as lawmakers from both parties pin all their hopes for a health care fix on a long-shot bipartisan bill to stabilize the insurance markets.

While there’s an effort underway within the GOP conference to try to hold another vote on a bill to overhaul former President Barack Obama’s signature domestic achievement, optimism is low among several Republican lawmakers and aides that it will be successful.

At the same time, hearings commenced Wednesday at the Senate Health, Education, Labor and Pensions Committee on how to best shore up an individual insurance market that continues to show signs of turmoil. Aides and lobbyists say members of the panel are waiting to see how the series of four hearings go before determining how best to proceed with what could become another bitter dispute between the two parties.

Skepticism is rampant in the Senate on whether the legislation will amount to anything more than funding for the subsidy payments to insurers included in the 2010 law that President Donald Trump has repeatedly threatened to end, something Republicans could have a difficult time agreeing to without more substantial changes.

Some hold hope that both parties can reach agreement on a final, albeit small, package of stabilization measures, at least in the Senate. Around 30 lawmakers attended a roundtable discussion Tuesday evening, which Sen. Susan Collins, R-Maine, said “bodes well for us getting some sort of agreement.”

Sen. Lamar Alexander of Tennessee, the HELP panel’s chairman, wants to move quickly, but negotiations are still in the early stages and it is unclear whether fast action is possible.

“I think we are still open to all sorts of ideas, but whatever we come up with has got to have bipartisan support,” Sen. Mike Rounds, R-S.D., said.

Repeal effort persists

Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana are also trying to corral support among governors and the White House for their proposal to overhaul the health care law. The two Republicans held a call with governors and their staff Tuesday.

Graham said Wednesday he does not believe his effort undermines the bipartisan work Alexander is spearheading.

“I don’t think there’ll ever be a bipartisan fix. I don’t think that’s even possible. I have no desire to prop up Obamacare,” he said. “We’re trying to find a way that’s really transformational, puts every state in the same standing.”

Lawmakers say it is unlikely leadership will try to advance the Graham-Cassidy bill under the budget tool known as reconciliation that would allow the GOP to pass the measure with only a simple majority.

There are many reasons why holding another vote on a repeal bill would be difficult. The schedule is tight in September and the to-do list for Congress remains long.

Republican senators also believe they still do not have the votes necessary to advance legislation with only GOP support. Senate Majority Leader Mitch McConnell did not mention health care Tuesday when he outlined the chamber’s September schedule.

But members continue to express at least some support for the Graham-Cassidy plan that would, in essence, provide massive block grants to the states for them to manage their own insurance markets.

“I think it’s a good add-on to another product, and I think it very well may be a long-term fix for a lot of the states that are out there. But I don’t think it’s the only path forward,” said Rounds, a former governor.

Deep divisions

Such a proposal, which would have a far-reaching impact on the insurance markets, is unlikely to win over enough Democrats to pass through regular order.

While optimism still remains that a bipartisan package is possible, the two parties remain divided on which policies to include.

Democrats want, among other things, more long-term funding for the health care law’s so-called cost sharing subsidies that help reduce out-of-pocket costs for low-income people. Republicans have repeatedly said they will not vote for legislation that simply provides money to insurance companies with no major changes.

One key demand for the GOP will be greater flexibility for states. But the provisions put into the most recent repeal proposals that would allow states to opt out of some regulations via waivers were bitterly opposed by Democrats.

The Senate HELP committee is taking the lead on the bipartisan bill, but the Finance panel, which has wide-ranging jurisdiction over health care issues, has also jumped in the fray and will hold a hearing next week on the issue, potentially complicating the effort. Finance Chairman Orrin G. Hatch of Utah appears to be seeking a far different bill than what Alexander and Sen. Patty Murray of Washington, the top Democrat on the HELP panel, are planning to put together.

“As Obamacare continues to fail, Congress must do more than simply bail out what has proven to be a broken system,” Hatch said in a statement. “This hearing will allow Senate Finance Committee members to hear from experts about the drivers of increasing healthcare costs and the importance of significant long-term reforms to Obamacare.”

Even if the Senate is able to cobble together some sort of package, it has a tight time frame. Insurers must soon finalize rates for fiscal 2018 and several aides privately speculated that any effort by Congress to lower costs for next year would come too late.

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