Michael Collins, USA TODAY NETWORK – Tennessee
Published 12:00 p.m. CT March
25, 2018
WASHINGTON
— No one thought it would be easy to get Democrats and Republicans on
board with a plan to stabilize the nation’s volatile health insurance markets.
But no one thought those efforts would collapse like this.
Months
of health-insurance negotiations led by two senators with a track record of
producing bipartisan bills ended abruptly last week amid a flurry of
finger-pointing and bitter charges by each side that the other was playing
politics.
It
wasn’t disagreements over health care subsidies or how to insure the
chronically ill that terminated the discussions. It was the messy politics of
abortion.
“I’m
disappointed – I’m angry about it,” an exasperated Sen. Lamar Alexander,
R-Tenn., said Friday, a few hours after Democrats blocked efforts to attach
health insurance legislation to a $1.3
trillion spending bill.
Alexander
described the last seven months of talks with Democrats and their lead
negotiator, Sen. Patty Murray of Washington, as “the most frustrating and
disappointing time in my 16 years in the Senate.”
Murray
said she’s also “extremely disappointed we’ve reached this point.” But, she
added, “it does not mean I’m giving up on getting this done.”
For thousands of
Americans, the breakdown in discussions could mean higher insurance rates this
fall. Unless Congress acts, premiums could jump by as much as 40 percent in
October for people who buy their insurance on the individual market instead of
getting it through their employer or from a government program, according to an
analysis by health care experts at the management consulting firm Oliver Wyman.
Alexander, who chairs
the Senate committee with jurisdiction over health insurance, said he sees no
way to avoid the premium increases. Republicans and Democrats have reached an
impasse, he said, and he sees no path forward.
“We’ve talked about it
until I’m blue in the face,” he said.
The acrimonious end to
the health insurance talks is remarkable given that Alexander and Murray have a
history of working harmoniously – and finding common ground – on other tough issues.
Three years ago, they
successfully pushed a bipartisan rewrite of the No Child Left Behind
school-reform law – a legislative journey so fraught with peril that Alexander
described it as having “alligators in every corner of the pond.”
The next year, they
again joined forces to pass a bipartisan bill to help accelerate the discovery,
development and delivery of innovative new medical treatments for diseases such
as cancer and AIDS.
Months of negotiations
When GOP efforts to
repeal the Affordable Care Act, or Obamacare, came up short last summer, the
senators stepped in to see if they could piece together a bipartisan plan to
keep insurance premiums from skyrocketing and stabilize health insurance
markets while Congress figured out its next step on the health care law.
But after seven months
and hundreds of hours of negotiations with Democrats, Alexander and other
Republicans announced last Monday they were moving forward with a GOP health
plan.
Their bill, which
included some provisions favored by Democrats, would restore for three years
the Obamacare subsidies paid to insurers that provide health-care coverage to
low-income clients. The proposal also would provide $30 billion in funding to
help states set up high-risk insurance pools to provide coverage for people
with high medical costs.
Democrats screamed
that they had been blindsided by the Republicans’ go-it-alone approach. The
first they heard about the GOP plan was when it was announced in a news
release, they said.
The politics of
abortion
Regardless, the
bipartisan negotiations clearly had hit an impasse. The stumbling
block: a ban on federal funding of abortions.
Since 1976, the use of
federal tax dollars to pay for abortions has been barred, except for limited
exceptions, under a law called the Hyde amendment.
Then-President Barack
Obama attempted a compromise eight years ago after Democrats in Congress passed
the Affordable Care Act without any Republican votes. The language Obama worked
out enabled individuals who receive federal subsidies to help pay for health
insurance to buy a policy that covers abortion as long as they used their own
money, not federal dollars, to pay for that coverage.
Murray and other
Democrats claim the bipartisan negotiations on health insurance were upended
when Alexander surprised them at the last minute by insisting that the Hyde
amendment restrictions must be applied to any health insurance legislation.
That would amount to an expansion of abortion restrictions and would
essentially mean Americans who buy a policy on one of the Obamacare
marketplaces would be unable to access abortion coverage even if they paid for
it with their own money, Democrats said.
The GOP bill “pulled
the most worn page out of the Republican ideological playbook: making extreme,
political attacks on women’s health care,” said Murray, the Senate health
committee's top Democrat.
Nonsense, countered
Republicans.
“This is nothing that
is radical or new,” said Sen. Susan Collins, a pro-choice Republican from
Maine, who pointed out that Democrats have gone along in the past when Hyde
restrictions have applied to Medicare, Medicaid and other government programs.
Alexander insists he
told Democrats all along that he intended to ask that the health insurance
proposal be included in the must-pass spending bill and that the Hyde
restrictions would apply. But House GOP leaders declined to attach the
insurance bill to the spending proposal. And in the Senate, Murray blocked an
effort by Collins to insert the insurance proposal into the spending plan.
The disagreement
escalated late last week into a volley of recriminations, with interest groups
and lawmakers on each side blaming the other for the stalemate and questioning
each other’s motives.
Republicans have
worked for eight years to undermine the Affordable Care Act, and the latest GOP
bill was just part of their plan to sabotage the law, said Brad Woodhouse of
Protect Our Care, a national coalition working to preserve Obamacare.
“I don’t think anyone
should be surprised that we’ve reached this point,” he said.
Infuriated Republicans
accused Democrats of deliberately disrupting the bipartisan talks so that
insurance rates would skyrocket and they could use that to bludgeon GOP
candidates in November’s elections.
“I hope you lose
votes,” Sen. Lindsey Graham, R-S.C., fumed at Democrats. “I hope you lose
seats. You're not worthy of governing this place.”
Murray insists she’s
ready to resume the bipartisan discussions. But Alexander said Democrats
already have rejected the only possible way to lower insurance rates this
October, so he sees no need to return to the table.
“I’m as willing as
anybody to try to work things out here,” he said. “But I’m no magician.”
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