Senate Democrats formally asked Republicans on Tuesday to cancel their plans to repeal Obamacare, insisting that the troubled health law’s future must be guaranteed before any of their members will work with the GOP.
Republicans said the request was an admission that Obamacare is in trouble, but added that the solution isn’t to double-down on more government control and the only way to rescue the health system is to free it from the restrictions the 2010 law imposed.
“We’re going to come up with a better product, more affordable, and keep the choices in the hands of consumers — exactly where it belongs,” said Sen. John Cornyn, Texas Republican.
Democrats’ role in the current debate generally has been to defend the 2010 Affordable Care Act and to taunt the GOP for its fits and starts at repeal.
Now as action shifts from the House to the Senate, where Democrats have a greater say, they’re beginning to face questions about whether they’ll play a constructive role in trying to stabilize the health insurance markets.
“Democrats stand ready — as we always have — to develop legislation with Republicans that will improve quality, lower costs, and expand coverage for all Americans. But Republicans need to set aside their current partisan efforts and work with us to get this done,” Senate Minority Leader Charles E. Schumer and his troops wrote in a letter laying out limits to their cooperation.
Democrats have floated ideas aimed at cutting costs by expanding the federal footprint in health care. They include creating a government-run “public option” to compete with private plans, offering more generous subsidies on the exchanges, allowing the government to negotiate down drug prices and lowering the eligibility age of Medicare, the government insurance program for those aged 65 and older.
“We’re not talking past each other, we’re asking to be in the room and they’re rejecting our overtures,” said Sen. Chris Murphy, Connecticut Democrat. “As long as they drop their repeal demands, we can talk about how to make these exchanges stronger. We want more financial stability in the exchanges, they want more flexibility in benefit design. I don’t know why we couldn’t have that conversation.”
Republicans say Obamacare is growing too expensive for the government and consumers. They say market-based solutions are the best way to address rising premiums and insurer exits that have threatened to leave vast parts of Iowa and Tennessee without a single insurer on their Obamacare exchanges next year.
A major insurer, Blue Cross Blue Shield, told Tennessee Insurance Commissioner Julie Mix McPeak that it is willing to fill the void in the Knoxville area, though it would need to charge higher-than-usual premiums unless Congress addresses three problems.
It cited a tax on health insurers, which is baked into Obamacare, and two factors linked to President Trump — his threat to withhold insurer reimbursements known as cost-sharing payments, and potentially lax enforcement of the individual mandate requiring healthy people to buy coverage.
For now, Senate Republicans emerging from closed-door huddles Tuesday said they were focused on what can attract enough votes from their 52-member conference, rather than the entire chamber.
“I’m of a mind that the divide is too great in terms of the financial underpinnings, which are substantially what are being talked about in this first phase,” said Sen. Thom Tillis, North Carolina Republican.
He said once Congress approves an initial repeal and moves on to additional changes that require 60 votes to flesh out the replacement plan, “then hopefully we can find common ground there.”
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