Ryan, White House reject bipartisan health fix

House Speaker Paul Ryan and the White House have informed Senate Republican leaders that they oppose a bipartisan plan to stabilize Obamacare being written in the Senate, according to Trump administration and congressional sources, in a clear bid to boost the Senate's prospects of repealing the health law. After Senate Republicans failed to repeal Obamacare in July, talks began on fixing the law rather than dismantling it. The dose of cold water from senior GOP officials will put pressure on Republican senators to back a last-ditch bill to gut Obamacare before a Sept. 30 deadline. Senate Majority Leader Mitch McConnell backed that approach publicly on Tuesday. Story Continued Below Republicans say that while the bipartisan talks between Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) initially seemed promising, many in the GOP fear providing money for Obamacare but offering little for conservatives — especially after Republican lawmakers have been throttled by President Donald Trump and the GOP base for failing to repeal the health law. Trump has threatened to withhold billions in Obamacare subsidies, which would upend private insurance markets. Alexander and Murray are working on legislation to have Congress provide those subsidies while allowing states more flexibility. But Republicans claim Democrats are not willing to bend enough. Democrats reject that claim and say it is intended to sink bipartisan negotiations. 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. The Congressional Budget Office said Monday it would not be able to provide full estimates on how the bill would affect insurance premiums or coverage for several more weeks. The bill would make deep spending cuts to Medicaid in the coming years; CBO has estimated that similar proposals would mean millions more would be uninsured. A senior White House official said there was never much interest in the Murray-Alexander talks and chalked it up to "the media talking about it,” though McConnell openly acknowledged the possibility that the two deal-making senators could strike a bargain. Trump listened to arguments for it and seemed intrigued, but it wasn't seriously considered as a possibility, this person said. The bipartisan proposal would continue subsidy payments and would not be seen as repealing Obamacare, this person said. Other White House officials said Graham-Cassidy isn't their ideal bill, but it's a "final chance to actually get something done," according to a second administration official. And in a significant development Tuesday, McConnell endorsed the Graham-Cassidy bill on the Senate floor, which must pass the Senate by month’s end to evade the chamber’s 60-vote threshold. He did not mention the bipartisan talks between Murray and Alexander. Graham-Cassidy is "an intriguing idea and one that has a great deal of support," McConnell said. Those two senators "know how important it is to move beyond the failures of Obamacare. They know that our opportunity to do so may well pass us by if we don't act soon." Democrats portrayed the rejection of the bipartisan push as intended to create pressure on Senate Republicans to hold their nose and support the Graham-Cassidy bill as the only way out of the party's political quagmire. If that bill fails, Republicans may have to return to bipartisan talks, particularly if Trump again threatens to halt subsidy payments. On Monday, Democrats said Murray was willing to make significant concessions to Alexander on more flexibility for states to run their health care systems if Obamacare subsidies were funded by Congress. “Murray has agreed to basically everything that Alexander has been asking for,” a Democratic aide said. If Democrats are able to perusade just three Republicans to endorse the stabilization effort, it could mark a death blow for the Graham-Cassidy bill, since it would suggest there are not 50 Senate Republicans willing to completely repeal Obamacare. Democrats say GOP leaders and the White House are trying to create a false sense of urgency with a deadline looming. “It’s crystal clear that Republicans are trying to shut down those negotiations in order to close off the better, more bipartisan path that moderate Republicans could take,” said a second Democratic aide. “They know that if they have a choice between a good bipartisan bill and Graham-Cassidy, some of them are likely to choose to former.”
Utne Altwire: healthcare

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