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Sen. Mike Rounds, R-S.D., thinks the GOP needs to continue discussing the nation's challenges when it comes to health insurance. (Tom Williams/CQ Roll Call)
Sen. Mike Rounds, R-S.D., thinks the GOP needs to continue discussing the nation's challenges when it comes to health insurance. (Tom Williams/CQ Roll Call)

Health care policy isn’t set to be a major focus of President Donald Trump’s first State of the Union address Tuesday, although some Republicans say the GOP needs to talk about the rising costs of health insurance.

Republicans on Capitol Hill say they don’t want Trump to shy away from talking about health care, despite the fact that the 2010 health care law remains mostly intact a year into the GOP-controlled Congress and Trump presidency. Some Republicans say they’d like to hear Trump encourage lawmakers to keep working to address rising premium costs.

“We recognize that it’s still there, and that people who are having 20 and 30 percent increases per year — because Congress has not yet addressed it — would be in a lot better shape if Congress were to actually come back through and begin the steps of stabilizing the market and moving forward with changes to allow the states to actually write their own plans once again,” said Sen. Mike Rounds, R-S.D., who worked on legislation meant to stabilize the marketplace created under the health care law.

“If they think that we’re simply ignoring it, they’re not going to be pleased,” he added.

Republicans are considering steps they could take to address premiums for insurance policies sold on the federal and state exchanges, which analysts have projected would spike as the repeal of the individual mandate takes effect next year.

That would require some refocusing for Republicans, who acknowledged this week that they can’t run away from the fact that their efforts to repeal the law fell short. Still, most are not pushing to try to overhaul the law this year.

Instead, lawmakers in both chambers are discussing legislation related to helping states set up reinsurance programs. Senators are discussing a bipartisan bill from Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., while Rep. Ryan A. Costello, R-Pa., has a House reinsurance bill that Energy and Commerce Committee members are discussing.

Experts say reinsurance programs that depend on government subsidies or high-risk pools could be effective in lowering premiums that are projected to go up after Republicans repealed the penalty for not having health coverage as part of the tax bill.

“Now it’s time to go on to the next things that are achievable, and that has to be tackling the cost of premiums,” said Rep. Michael C. Burgess, R-Texas, the chairman of the Energy and Commerce Health Subcommittee.

Focus on Opioids

But the State of the Union isn’t necessarily the right forum for discussing that, some say.

Talking about the health care law could highlight a political failure, said Joe Antos, a scholar at the right-leaning American Enterprise Institute. Instead, Trump is likely to touch on opioids and perhaps high drug costs, which would be a bipartisan applause line, he said.

“On the Republican side, to the extent that somebody feels like they need to talk about health care, they’re going to say, ‘We got rid of the single worst provision of the ACA,’” Antos said, referring to the health law’s individual mandate to get coverage. “They should fixate on the actual accomplishments that their constituents strongly believe in, and clearly the tax bill is it, and health care is not it.”

Opioids are expected to be addressed on Tuesday night: One of Trump’s guests is a police officer who adopted a baby born to parents addicted to opioids. And it’s an issue that lawmakers in both parties are eager to talk about.

“It’d be another good place for him to remind the country of what a critical issue that is and how it needs to be dealt with,” said Sen. Roy Blunt, R-Mo., who oversees the appropriations subcommittee related to health and human services.

Senators on both sides of the aisle have said they expect that any potential deal to lift the spending caps would provide new funding for opioids, although most stopped short of saying how much they hope to provide.

“Congress is ready to act. We’re waiting for some final decision on how much we have to act with,” Blunt added.

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