President Trump told senators he would support a new deal to stabilize Obamacare markets in exchange for repealing Obamacare’s individual mandate, several senators said Tuesday.
Trump met with the Republican conference on Tuesday during their weekly lunch to discuss tax reform legislation, which is expected to be brought up for a vote as early as this week. Several senators said after the lunch that Trump gave his support to a deal to stabilize the law’s exchanges, brokered by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash.
In addition to the Alexander-Murray deal, Trump would support a bill from Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., that would provide roughly $4.5 billion in reinsurance funding over two years, Alexander said after the lunch.
Collins has been a frequent critic of the GOP leadership’s efforts to repeal the mandate in the tax bill. She also voted against a “skinny” repeal bill in July that would have repealed it.
But she hinted that she may be coming around to supporting mandate repeal, if there is a deal to stabilize the Obamacare markets.
“I do recognize that there is a big difference between allowing people to choose going without insurance versus what we were faced with last summer and fall where insurance was going to be taken away involuntarily from people,” she said.
Collins said Alexander-Murray and her own bill are needed, as estimates show insurance premiums would rise if the mandate is eliminated. That is because an incentive for younger and healthier people to sign up for Obamacare would disappear, and insurers are worried that would cause an exodus from the law’s exchanges.
Collins said she talked with members and leaders on the Senate Finance Committee about a stabilization deal and her bill on Obamacare reinsurance, which would provide funding to insurers to help offset the sickest claims from customers.
The deal and the amendment would be taken up after the tax legislation is passed and in conference with the House, Collins said. But she noted that the specific vehicle for the deal hasn’t been decided on.
Sen. John Thune, R-S.D., a member of GOP leadership, added that they have to “figure out exactly what it is we want to do with what the substance of it is, and then we’ve got to find a vehicle.”
Thune added that Collins met privately with Trump to address her concerns about the tax bill, which includes the elimination of the state and local tax deduction. Collins is pursuing an amendment similar to a compromise reached in the House to blunt the impact of eliminating the deduction, which would hit residents in high-tax states hard.
The support would be contingent on the individual mandate repeal remaining in the tax legislation. The mandate forces everyone to buy insurance, but some senators have been worried that repealing the law’s penalties would lead to higher premiums and have called for an agreement to bring up Alexander-Murray to help blunt the impact of that.
Democrats charge, however, that Alexander-Murray is not enough to help protect consumers from the impact of repealing the mandate.
Alexander-Murray makes cost-sharing reduction payments to insurers for two years and in return gives states more flexibility to waive Obamacare insurance regulations. The payments reimburse insurers for a requirement to lower co-pays and deductibles for low-income Obamacare exchange enrollees.
The deal was released last month and has support among 12 Republicans and all Democrats. However, Senate Majority Leader Mitch McConnell has not brought it up for a vote because of opposition from Trump and House Speaker Paul Ryan.
Thune said that the deal could be a stopgap measure until Congress tries again to repeal and replace the Affordable Care Act.
“Most of us look at this as a sort of runway to get to what we hope will eventually be something along the lines of Graham-Cassidy where we would do a more systemic fix for Obamacare that shifts money back to the states,” said Thune, referring to a replacement bill from Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., that failed in September. “In the meantime you’ve got to deal with the issues that are cropping up in the foreseeable future.”
• Washington Examiner reporter Kimberly Leonard contributed to this report.
