Trump reverses course on Alexander’s Senate health care deal

Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander. R-Tenn., chairman of the Senate Health Committee, meet before a hearing at the Capitol, Oct. 18, 2017. The day before they reached a deal to resume federal payments to health insurers that President Trump had halted. (AP Photo/J.Scott Applewhite)

WASHINGTON (AP) — The chief sponsor of the bipartisan Senate deal to curb the growth of health insurance premiums is responding to a shift in support from President Donald Trump. Sen. Lamar Alexander, R-Tenn., said President Trump called to offer encouragement, a day after the president spoke favorably of the pact but then reversed course.

The mixed signals from the White House have created confusion even as voters face the prospect of dramatic premium spikes without congressional action.

“I think he wants to reserve his options,”  Sen. Alexander told an Axios forum on Wednesday after the president’s call. Alexander said Trump wanted “to be encouraging,” and the senator predicted that his deal would pass “in one form or another” by year’s end.

But that outcome looked increasingly uncertain in face of conservative backlash to the deal and Trump’s own erratic signals.

Trump tweeted Wednesday morning: “I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co’s who have made a fortune w/ O’Care.”

Trump’s quickly shifting stances angered Senate Minority Leader Chuck Schumer of New York, who took to the Senate floor Wednesday morning to accuse Trump of backing down on this issue and others whenever the hard right objects.

“This president keeps zigging and zagging so it’s impossible to govern,” Schumer said. “Our only hope is that maybe tomorrow he’ll be for this again.”

Trump stopped federal payments to health insurers last week that keep costs down for low-income consumers. Alexander and Sen. Patty Murray, D-Wash., announced a deal on Tuesday to restore them along with changes to give states more flexibility.

Insurers had warned that unless the money was quickly restored, premiums would go up and prompt some carriers to abandon unprofitable markets.

In remarks Tuesday in the Rose Garden, Trump called the deal “a very good solution” that would calm insurance markets, giving him time to pursue his goal of scrapping the Affordable Care Act, the target of Republican derision since it was signed into law in 2010. But Trump backed off later Tuesday after a day of criticism from many in the GOP.

In an evening speech at the conservative Heritage Foundation, he said that “while I commend” the work by the two senators, “I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies.”

The subsidies Trump ended go to insurers for reducing out-of-pocket costs for lower-income people. Since Obama’s law requires insurers to make those cost reductions, insurers and others have warned that halting the subsidies would force premiums higher and prompt some carriers to abandon unprofitable markets.

“This agreement avoids chaos,” Alexander said Tuesday. “I don’t know a Republican or Democrat who benefits from chaos.”

Senate Majority Leader Mitch McConnell, R-Ky., was noncommittal about the agreement. “We haven’t had a chance to think about the way forward yet,” he said.

Aides to House Speaker Paul Ryan, R-Wis., did not provide a statement from him.

Both McConnell and Ryan have been eager to turn national attention away from the GOP push to scuttle Obama’s law, which crashed in the Senate twice, and toward an effort to cut taxes.

Reaction from other Republicans toward the Senate agreement was mixed. For many conservatives it’s practically unthinkable to sign off on federal payments that would arguably prop up a law they’ve been vowing for seven years to destroy.

Rep. Mark Walker of North Carolina, chairman of the conservative Republican Study Committee in the House, tweeted: “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”

Freedom Caucus Chairman Rep. Mark Meadows, who’s been at work on a proposal of his own, was slightly more positive, calling the Alexander-Murray bill “a good start” but saying much more work needed to be done.

Alexander said he and allies including Sen. Mike Rounds, R-S.D., would spend the next several days trying to build up support with the goal of formally introducing legislation later this week. If the legislation does pass, it would almost certainly be as part of a larger package including must-pass spending or disaster relief bills and that might not be until the end of the year.

The deal includes provisions allowing states faster and easier access to waivers that would allow them to shape their own marketplace plans under the health law.

It would provide for a new low-cost catastrophic coverage insurance option for all consumers. It would also restore $106 million for outreach and enrollment programs aimed at prodding people to buy policies — efforts that Trump has slashed.

A federal judge ruled in a 2014 lawsuit brought by House Republicans that Congress never legally authorized spending money for the insurers’ subsidies. Obama and Trump, initially, continued making the payments, though Trump declared last week he would pull the plug.

The payments, which cost around $7 billion this year, lower expenses like copayments and deductibles for more than 6 million people. But discontinuing them would actually cost the government more money under the health law’s complicated structure, because some people facing higher premiums would end up getting bigger tax subsidies to help pay for them.