Bipartisan health care deal remains elusive in the Senate as parties dig in ahead of next week’s vote
Washington (CBS NEWS) — CBS News reports that a bipartisan deal on health care remains elusive in the Senate with a key vote on Affordable Care Act tax credits set for next week.
“The conversations continue,” Senate Majority Leader John Thune said Tuesday. “I don’t think at this point we have a clear path forward, I don’t think the Democrats have a clear path forward — and they’re the ones that are going to have to put forward their plan to get voted on next week.”
A group of Senate Democrats last month secured a vote to address expiring Affordable Care Act enhanced tax credits, which were at the heart of the government shutdown fight, as part of the deal to reopen the government. That vote is set to occur next week, when Democrats will have the opportunity to present the legislation of their choice.
Democrats could pursue a compromise position that stands a chance at earning the 60 votes needed to advance, or they could seek an extension that wouldn’t pick up enough support from Republicans but would force GOP members to take a politically uncomfortable vote. Millions of Americans are due to see their health insurance premiums skyrocket in the new year without action from Congress.
Dwindling prospects for a bipartisan compromise
Republicans have been critical of the Affordable Care Act since it became law in 2010. But with premiums set to rise with the expiration of the tax credits, which help pay for health insurance premiums for plans purchased on state exchanges, some GOP lawmakers have acknowledged a need for a short-term extension. And the planned vote next week puts pressure on Republicans to come together on a strategy.
Thune, a South Dakota Republican, said Tuesday that there are some in the GOP conference who want to work with Democrats “in a constructive way on something that could be a bipartisan solution, but that hasn’t landed yet.”
Among the issues at the center of the impasse is the Hyde amendment, which restricts federal funding for abortions. Thune called it a “difficult, challenging” issue for both sides. The majority leader told reporters Wednesday that “our members are very committed, obviously, and with good reason, to ensuring that the Hyde protections apply to Obamacare policies.”
“The Democrats clearly have a different view, and that has always been probably one of the biggest obstacles to getting a deal,” Thune said. “That one is a really challenging one.”
Senate Minority Leader Chuck Schumer said “as long as Republicans are wedded to expanding Hyde, they can’t even talk about anything else.”
On Democrats’ position more broadly, the New York Democrat said Tuesday that “we’re willing to talk to anybody who’s willing to lower costs,” but he claimed “the Republicans are in total disarray and have no plan.”
Democratic Sen. Chris Murphy of Connecticut, a top progressive voice in the chamber, told reporters Tuesday that he wants a clean, multi-year extension of the tax credits, “but I understand that’s not likely to get 13 Republican votes.”
“So yeah, I’m certainly open for a one-year extension, some restrictions on income,” he said. “But it just doesn’t seem like Republicans are interested in anything. I mean, they might not even offer their own proposal because it appears that they can’t even get 53 votes on anything related to extending these subsidies.”
Republicans work to coalesce around a strategy
Thune said Senate Republicans had a “robust discussion” at their conference lunch meeting Tuesday and heard from two top committee chairs. But there was no apparent breakthrough. He said Republicans “continue to coalesce” around a health care solution, with a number of ideas percolating in recent weeks.
Multiple Senate Republicans said after the lunch meeting that they expect that GOP leadership will put forward a bill alongside the Democrat-led ACA measure for Republicans to vote on if Democrats pursue a partisan approach, a move which would alleviate pressure on their conference. But Thune said until they know what the Democrats are planning to put forward, “we won’t probably have our strategy ready.”
Without a negotiated bipartisan approach, neither bill would be likely to get the votes needed to advance. And what that GOP legislation looks like remains to be seen.
Sen. John Hoeven, a North Dakota Republican, told reporters that “if the Democrats want to keep working, we’re willing to do that.”
“If they say, ‘nope, we want to have a vote,’ we’ll have a plan,” Hoeven said. “It’s not finalized yet, but we’ll obviously have something ready to go. We’ve got a lot of good ideas.”
Sen. Bill Cassidy, a Louisiana Republican, has outlined his proposal aimed at lowering health care costs in recent weeks. His plan would take roughly the same amount of money that would be needed to extend the enhanced ACA tax credits and put that into health savings accounts for those who use bronze plans. The idea is that people would save on premiums by switching to the bronze plans, while they would also be able to use the HSA funds toward their deductibles.
Meanwhile, Sen. Rick Scott, a Florida Republican, unveiled another proposal ahead of the Thanksgiving break. Scott framed his bill as something that could drive down costs by giving people options. The proposal would create HSA-style accounts to pay for health insurance.
“Mine’s pretty simple — if you like your Obamacare, keep your Obamacare,” Scott told CBS News.
Sen. Josh Hawley, a Missouri Republican, told reporters Tuesday that he plans to pitch a proposal to effectively end taxes on health care costs. He said the idea would work in conjunction with “some form of premium support.”
Thune also lauded an idea that would allow individuals to sign up for “association” health care coverage, in which small businesses and the self-employed collectively purchase coverage to lower costs. The proposal would allow companies like Costco and Walmart to offer health policies across state lines.
“I think it’s a great idea, something we’ve been for for a long time,” Thune said. “It’s always been resisted by Democrats, but buying across state lines, allowing people to join larger groups, to get into the group market, out of the individual market … That is a way that you could significantly address the issue of cost and affordability.”
Waiting on the White House
The debate within the Senate GOP is happening in anticipation of input from the White House. Last week, reports indicated that the White House was planning to propose a two-year extension of Affordable Care Act tax credits with new limits. But the proposal seemed to dissipate after GOP lawmakers resisted, and President Trump told reporters he prefers a plan to give money directly to people over insurance companies and would rather not extend the subsidies.
“Somebody said I want to extend them for two years, I don’t want to extend them for two years,” Mr. Trump told reporters aboard Air Force One. “I’d rather not extend them at all. It may be, some kind of an extension may be necessary to get something else done, because the Unaffordable Care Act has been a disaster.”
As the president’s advisers were drafting a plan to continue the subsidies for an additional two years, Speaker Mike Johnson had told the White House in a phone call with senior administration officials that most House Republicans have little interest in extending the Affordable Care Act’s enhanced subsidies, sources familiar with the conversation told CBS News.
White House National Economic Council Director Kevin Hassett outlined the back and forth on “Face the Nation with Margaret Brennan” on Sunday.
“Sometimes people leak pre-decisional things that are confidential and pre-decisional,” Hassett said. “And I think that somebody did that, and then it rolled back because it hadn’t been through the whole process, but President Trump has been clear that he’s very concerned about the cost of health care.”
Hassett predicted that “people are going to work this out” before Christmas. He added that the White House has “a solution for cost-sharing, and the Democrats have an alternative.”
