Senate health care talks flicker to life as ObamaCare deadline nears

 A bipartisan group of senators is making a renewed push toward finding a health care solution as the hour-glass winds down to the end-of-month deadline to extend the enhanced Affordable Care Act (ACA) subsidies.

Roughly 20 senators met Monday night at the invitation of Sen. Susan Collins (R-Maine), with lawmakers using a proposal from her and Sen. Bernie Moreno (R-Ohio) — which includes a two-year extension of the ACA tax credits and reforms aimed at winning over conservatives — as a jumping off point. 

Multiple key negotiators indicated they were buoyed by the meeting and expect conversations to continue, with some even saying a framework of a deal could come about by the end of the week.

“There is widespread support for producing a result,” Collins told reporters when she emerged from the meeting alongside Moreno. “There was no grandstanding. People were very practical and they want a result.” 

The senators cautioned, however, that reaching a deal before they break for the holidays is likely not feasible, with January representing a more realistic target.

The group of lawmakers consisted of those from across the political spectrum in both parties, including members of both leadership teams, moderates, and those in conservative and progressive camps.

The meeting came only days after the chamber voted down a pair of partisan health care bills that essentially turned into a messaging exercise. 

A plan offered by Sens. Mike Crapo (R-Idaho) and Bill Cassidy (R-La.) sought to shift funding for the subsidies to become contributions toward health savings accounts in order to help cover out-of-pocket costs for those who are insured via the ACA marketplace. It failed to advance on a nearly party-line vote.

The Democratic measure, which Senate Majority Leader John Thune (R-S.D.) agreed to put on the floor as part of the deal to reopen the government last month, would have extended the enhanced subsidies for three years.

Democrats notably won the support of four Republicans: Sens. Lisa Murkowski (Alaska), Dan Sullivan (Alaska), Josh Hawley (Mo.) and Collins. And senators credited the failed votes for the renewed push toward getting a deal.

“I think sometimes, Democrat bill, Republican bill — fail, fail —maybe helps with the momentum,” Sullivan, who is up for reelection next year, told reporters. “This is a really serious issue for great Alaskans who are going off this cliff through no fault of their own.”

According to attendees, senators tossed out scores of ideas and concerns during the hour-plus meeting. Among them were the potential guardrails and reforms to the subsidies, and how many years an extension should include. 

Collins added that one issue the group discussed is the possibility of extending open enrollment. Most ACA state exchanges allow individuals to sign up for plans until Jan. 15, but anyone who wanted insurance on Jan. 1 had to be signed up by Monday. 

Republicans also brought up potential ways to address the issue of abortion after conservatives pushed to include a Hyde Amendment-like provision barring federal funds from going toward abortion in any health care package.

Perhaps most of all, the meeting sought to cool temperatures that have been simmering for weeks.

Republicans have accused Democrats of not truly wanting to solve the problem and preferring to keep the issue alive ahead of next year’s midterm elections. 

Democrats have similarly panned Republicans for allowing the subsidies to expire and cause health care costs to soar for millions of Americans.

“I think we’re in a … very positive approach to try to solve the problem,” said Senate Minority Whip Dick Durbin (D-Ill.). “We certainly moved in that direction.”

“It’s perilously close to something called legislating, which used to be common in the Senate and hasn’t been in a long time,” he added. 

Despite the positive steps, pessimism continues to seep in among lawmakers who believe that a deal remains too far out of reach for both sides, especially given the abbreviated runway negotiators have to land the legislative plane. 

Democrats, at least publicly, are still holding out for a clean extension of the ACA subsidies.

Republicans, meanwhile, are split on the issue. Moderates have been warning for years that allowing health care costs to spike will cost them in the midterms while conservatives have blanched at the idea of voting to extend subsidies under ObamaCare, which they’ve battled for more than a decade.

In the House, leadership is aiming to vote on a GOP-crafted health care package this week that doesn’t include an extension of the subsidies. An amendment proposed by moderates to address the subsidies appeared to hit major roadblocks.

At the same time, there are three active discharge petitions — two from GOP moderates and one from Democratic leaders — that could force a bill to extend the enhanced subsidies to the floor if one receives enough signatures.

Senate Majority Leader John Thune (R-S.D.) told reporters that despite bipartisan talks continuing through the weekend into Monday, he was not “terribly optimistic” that a result would come about, especially one that could get the requisite 60 votes. 

“Those conversations continue, but there isn’t anything I would say at the moment … that can probably be something signed into law,” Thune said. 

Other top lawmakers were more blunt about the challenge facing the bipartisan group. 

“Lots of people have been able to pull legislative rabbits out of a hat,” said Sen. Brian Schatz (D-Hawaii), a member of Democratic leadership. “But that’s what this would be.”

https://thehill.com/homenews/senate/5650544-senate-health-care-talks-obamacare/