Monday, March 26, 2018

Bipartisan push for Obamacare fix unravels in Senate over abortion, charges of politicking


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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