So much for the two-track idea floated yesterday. Sen. Lamar Alexander had been working on a bipartisan stabilization bill for ObamaCare exchanges in case Republicans failed to pass a repeal by the September 30th deadline. That outcome still seems more likely than not, even now with Graham-Cassidy making progress, and will leave millions of Americans vulnerable to a collapse in the exchanges in the very near future. However, such a stabilization bill would almost certainly create a bailout for insurers, in practice if not in expressed intent.
Both Paul Ryan and the Trump administration consider that a “red line” that neither will cross:
The “speaker is drawing a red line” and said the House “would not be able to pass a bailout of insurers,” said one congressional source familiar with the dynamics. “The White House also told GOP leaders that [Obamacare subsidies] without repeal would not work.”
A House source familiar with the conversation confirmed that a call between Ryan and Senate GOP leadership occurred in which the stabilization approached was sidelined. A second House Republican source said a stabilization bill “would definitely make some in our conference pretty upset if we took it up.”
“Our focus is on repealing and replacing this failing law, and we are encouraged the Senate is making progress,” said AshLee Strong, a spokeswoman for Ryan.
Instead, Ryan and the White House are backing the repeal bill written by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) that would turn federal health care programs into state block grants, repeal Obamacare’s coverage mandates and wind down the law’s Medicaid expansion while capping the entitlement program’s spending for the first time.
Alexander’s bill always looked like a long shot. All Ryan has done is to make the obvious clear — that the Freedom Caucus simply won’t sign onto an ObamaCare rescue, especially one that creates a perpetual pipeline to insurers to reimburse its red ink. The real news is that the White House has firmly come down on that same position. At times, it seems as though Donald Trump wants legislative wins more than he wants a fight over the agenda, but this time the administration has decided to link up with Ryan to stop the bailout.
In one sign that the message has been received, Mitch McConnell called for a vote soon on Graham-Cassidy:
The U.S. Senate’s top Republican on Tuesday urged quick action on a bill to repeal Obamacare but stopped short of promising to bring it to the Senate floor for a vote, as the clock ticks down on the latest attempt to kill the 2010 healthcare law.
Mitch McConnell, the Senate’s Republican leader, called the legislation drafted by senators Lindsey Graham and Bill Cassidy “an intriguing idea and one that has a great deal of support.”
Lawmakers should act because “our opportunity to do so may well pass us by if we don’t act soon,” McConnell said on the Senate floor.
Depending on the form it takes, the Washington Post notes, it might still run afoul of other red lines in the House Republican caucus even if it does manage to eke through the Senate:
Make no mistake, the pressure on GOP House members to make good on their eight-year promise to repeal the Affordable Care Act would be enormous, and several House Republican aides and members said Monday that they expect members would be squeezed in a political vise of epic proportions until the measure passes.
“It will truly be a binary choice when it comes to the House for an up-or-down vote,” Rep. Mark Meadows (R-N.C.), chairman of the hard-right House Freedom Caucus, said Monday. “It’s going to be just a yes or no.” …
Meadows, for one, said much depends on how the Senate bill might change in the coming weeks. Changing the bill too much to attract a GOP moderate like Sen. Lisa Murkowski (Alaska) could make the bill unpalatable to conservative hard-liners in the House, and Meadows said he and other House members are engaged behind the scene to prevent that from happening. For the time being, he said, he supports the bill and believes it will pass the House.
But the bigger obstacle may be House moderates — particularly from the states of California and New York, which stand to lose tens of billions of dollars in federal health-care funding under the Graham-Cassidy framework. The bill as currently structured takes the money already set to be sent to states for Medicaid and ACA subsidies, pools it, and distributes it as few-strings-attached block grants.
If the Senate passes it, the House may have little choice but to go along. So far, they’ve avoided the harsh blowback that has fallen on the upper chamber since the failure to pass the BCRA in July. A rejection by the House of a Senate-passed reconciliation bill could prompt Trump to rethink his red lines, and start considering closer partnerships with Democrats on ObamaCare fixes rather than replacements. But first, the bill has to pass the Senate — and that still looks like a long shot to cross the finish line, whether or not it looks red to anyone.
Update: An unnamed White House source tells CNN that Trump would sign Graham-Cassidy … assuming Congress can pass it:
President Donald Trump would sign the Graham-Cassidy bill if the legislation to repeal Obamacare makes it to his desk, an administration official told CNN Tuesday.
A source tells CNN that the White House has been working with Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana for weeks on the new effort, and a second source added that Trump himself had quietly encouraged the two senators to take another shot at health care.
Will that push McCain, Murkowski, and Collins over the line?
Update: Come on, no one expects results this soon:
AFTER THE GOP MEETING on Graham-Cassidy: Spoke to McCain, Collins and Murkowski; no shift in any of their positioning since yesterday.
— Sahil Kapur (@sahilkapur) September 19, 2017
They won’t make any moves until the CBO score comes back.