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Republicans Try to Regroup After Health Care Failure; Democrats Exult Lawmakers Have Bipartisan Health Ideas. Now To Persuade Their Leaders ...
(about 7 hours later)
WASHINGTON — Hours after their seven-year pledge to dismantle the Affordable Care Act hurtled off the rails in the Senate, Republican lawmakers pointed fingers at their own on Friday for letting their voters down. Democrats exulted in blocking the repeal effort, at least for now. WASHINGTON — Congressional lawmakers said on Friday that the collapse of Republican efforts to demolish the Affordable Care Act had created an opening for bipartisan work to shore up health insurance markets and protect consumers against sharp increases in premiums.
For House Republicans — who in May passed a bill, at no small political peril to several vulnerable members, to upend President Barack Obama’s signature domestic achievement — the message was clear: We did our job. And the Senate must not give up. But any such effort would have to overcome the firm resistance of President Trump and Republican leaders on Capitol Hill who have refused to participate in any effort to fortify President Barack Obama’s health law.
“They’ve got to get back at it,” said Representative Tom MacArthur, Republican of New Jersey. The professions of a desire for bipartisan cooperation were as profuse on Friday as the short-term outlook for tangible results was grim.
“They’ve got to keep voting,” said Representative Thomas Massie, another Kentucky Republican, going a step further to suggest that Senate Republicans who stood in the way of the repeal should be removed at the ballot box. “On health care, I hope we can work together to make the system better in a bipartisan way,” said the Senate Democratic leader, Chuck Schumer of New York, who led efforts to preserve the Affordable Care Act. “And I’m optimistic that that can happen,” he added, saying that he recognized flaws in the law.
“I think the voters need to do a little more sorting of the people who are serving up here,” he said. The Republicans’ seven-year promise to repeal the Affordable Care Act seemed to come to an end in the early hours of Friday when 51 senators — including three Republicans — blocked a narrow version of repeal that would have rolled back only a few provisions of the sweeping health care law.
The Democratic leaders in both chambers, Senator Chuck Schumer of New York and Representative Nancy Pelosi of California, urged Republicans to abandon the push for a repeal once and for all and join them in patching up problems in the existing health law. Without a Republican majority to approve either a comprehensive replacement for the health law or a repeal-only bill, Republican leaders had fallen back on what they called the lowest common denominator. And that failed, too.
“Right now we go forward recognizing the value of the Affordable Care Act,” Ms. Pelosi told reporters on Friday. “But we also know that there are updates and improvements we need to make.” Senator John McCain, Republican of Arizona, who cast the decisive vote against the Republican bill around 1:30 on Friday morning, appealed for a bipartisan approach. “The vote last night presents the Senate with an opportunity to start fresh,” he said.
President Trump has suggested little appetite for this approach. The Affordable Care Act “was rammed through Congress by Democrats on a strict party-line basis without a single Republican vote,” Mr. McCain said, and Republicans must not make the same mistake.
Early Friday morning, just after the vote, he seemed to reiterate a preference for allowing the health law to falter under the expectation that Democrats’ leverage will be weakened down the line, causing them to embrace right-leaning remedies. But there was no hint of an olive branch from the Senate majority leader, Mitch McConnell, who this summer suggested that a failure to repeal the Affordable Care Act would force him to work with Mr. Schumer.
“As I said from the beginning, let Obamacare implode, then deal,” Mr. Trump tweeted shortly after the vote. “Watch!” “Bailing out insurance companies with no thought of any kind of reform is not something I want to be part of,” Mr. McConnell said in the early hours of Friday. He suggested that many Democrats secretly wanted a single-payer health care system, with a much larger role for the government.
Several Republicans have raised concerns with this strategy. “I don’t want to cause hardship for a lot of people,” said Representative Charlie Dent of Pennsylvania, who voted against the House bill in May. “Bipartisan plans are out there.” President Trump reiterated his threat to force the health law to collapse. “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!” he wrote on Twitter.
Hours after his initial message, Mr. Trump returned to another idea he has floated: doing away with the legislative filibuster in the Senate, which requires 60 votes on most legislation. He tweeted this strategy even though the health law was considered under circumstances that required a simple majority. And some Republicans did not sound ready to close the door on repeal, despite the exceedingly slim hopes of reviving, yet again, an effort that on Friday morning seemed doomed.
“If Republicans are going to pass great future legislation in the Senate, they must immediately go to a 51 vote majority, not senseless 60,” he wrote on Twitter. “Even though parts of health care could pass at 51, some really good things need 60. So many great future bills & budgets need 60 votes.” “I am disappointed and frustrated, but we should not give up,” said the House speaker, Paul D. Ryan of Wisconsin. “I encourage the Senate to continue working toward a real solution that keeps our promise.”
Some Republicans, left to grapple with the fallout of the repeal failure, opted instead for collective self-flagellation. If a bipartisan coalition can coalesce around changes to the Affordable Care Act, lawmakers see several vehicles to force such proposals to the floors of the House and Senate. Spending bills for the fiscal year that starts Oct. 1 will have to be signed, and the popular Children’s Health Insurance Program will need additional funds.
Representative Brian Mast, Republican of Florida, was asked if lawmakers might face consequences in next year’s midterm elections if they could not keep their promise to undo the law. And the ideas are out there. Democrats want to provide money to insurers to reduce out-of-pocket expenses for poorer consumers, a proposal with some Republican backing. An earlier version of the Senate Republican repeal bill would have continued such cost-sharing payments through December 2019.
Two Democratic senators, Thomas R. Carper of Delaware and Tim Kaine of Virginia, have introduced legislation that would authorize the federal government to help pay the largest health insurance claims through a backstop known as reinsurance. That, they argue, could substantially reduce insurance premiums.
An earlier version of the Senate Republican bill included a similar concept, a $182 billion “state stability and innovation program.” Senators assumed that much of the money would be used for reinsurance arrangements.
Senators of both parties want to help consumers in counties where no insurer offers health plans under the Affordable Care Act marketplace — a real possibility next year as insurers retreat from the health law’s marketplaces.
Senators Lamar Alexander and Bob Corker of Tennessee, both Republicans, want to allow consumers in such counties to use tax credits to buy insurance outside the public marketplace. Senator Claire McCaskill, Democrat of Missouri, would allow them to obtain coverage through the insurance exchange in the District of Columbia, which serves many members of Congress.
Moderates in both parties have been talking behind the scenes, but it is unclear whether they would need or receive permission from their party leaders to cooperate more. Party leaders are continually weighing the implications of health care for next year’s midterm elections.
Mr. Alexander, a former governor who is the chairman of the Senate health committee, is seen as a possible deal maker. He intends to hold hearings on possible solutions to the problems plaguing insurance markets in some states including his own.
Senator Joe Manchin III, Democrat of West Virginia and another former governor, said he saw the Senate’s 11 former governors as a potential source of pragmatic bipartisan solutions.
Senator Susan Collins, Republican of Maine, who voted against repeal, said: “The A.C.A. is flawed and in portions of the country is near collapse. Rather than engaging in partisan exercises, Republicans and Democrats should work together to address these very serious problems.”
But some Republicans may not be so eager to collaborate. Representative Mark Meadows, Republican of North Carolina and the chairman of the hard-line Freedom Caucus, made clear that he was not ready to step away from the repeal effort, and said Mr. Trump shared that view.
“I’m optimistic we can still get it done,” Mr. Meadows said on Fox News. “The people are losing faith, but we’re going to stay in. I can tell you who’s staying in: The president is staying in on this fight. He’s going to deliver.”
Senator John Kennedy, Republican of Louisiana, also vowed to keep trying. “Being defeated is temporary,” he said. “Tell you what’s permanent. What’s permanent is giving up, and I can tell you I’m not going to give up.”
Mr. Trump has repeatedly threatened to cut off the payments that compensate insurance companies for reducing out-of-pocket costs for low-income people. He wants to stop these cost-sharing reduction payments, and senior administration officials seriously discussed the idea at recent meeting that ended without a decision.
Administration officials said they fully expected insurers to sue if the government halted the payments, whose legal status is already in doubt because of a lawsuit filed by House Republicans during the Obama administration. Insurers say that cutting off the payments could cause havoc in insurance markets.
In the House, Republican lawmakers pointed fingers at their Senate colleagues on Friday for letting down their voters. For House Republicans — who succeeded in passing a repeal bill in May, at no small political peril to some of their vulnerable members — the message was clear: We did our job. And the Senate must not give up.
“They’ve got to get back at it,” said Representative Tom MacArthur of New Jersey.
Some Republicans, left to deal with the fallout of the repeal failure, opted instead for collective self-flagellation. Representative Brian Mast of Florida was asked if lawmakers might face consequences in next year’s midterm elections if they could not keep their promise to undo the law.
“Everybody should,” he said. “If we don’t get the No. 1 job that we said that we would do done, yeah, people should be held accountable.”“Everybody should,” he said. “If we don’t get the No. 1 job that we said that we would do done, yeah, people should be held accountable.”
Then there was the scene at a meeting of Republican House members on Friday morning. Then there was the scene at a meeting of Republican House members on Friday morning. According to lawmakers, the gathering included a recitation of lyrics from “The Wreck of the Edmund Fitzgerald,” a Gordon Lightfoot song about a sinking ship, which was likened to the Senate’s stumble.
According to lawmakers, the gathering included a recitation of lyrics from “The Wreck of the Edmund Fitzgerald,” a song about a sinking ship, which was likened to the Senate’s stumble.