The Republican party appears to be sending differing signals following the collapse of Senate GOP efforts to overhaul the Affordable Care Act, known as Obamacare.
President Donald Trump has, in recent days, ramped up calls for the Senate to vote on healthcare before considering any other legislation.
“Don’t give up Republican Senators, the World is watching: Repeal & Replace … and go to 51 votes (nuke option), get Cross State Lines & more,” Trump tweeted Sunday morning.
He tweeted on Saturday that “Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!”
Mick Mulvaney, director of the White House Office of Management and Budget, doubled down on Trump’s stance on CNN’s “State of the Union” on Sunday.
When host Jake Tapper asked whether it was the White House’s official policy that no other legislation proceed until the Senate moves on healthcare, Mulvaney replied affirmatively and said that the president was “simply reflecting the mood of the people.”
“Go and poll the American public and find out what the most important issue is to them right now, and it’s healthcare,” Mulvaney said. “So, in the White House’s view, they can’t move on in the Senate.”
Health and Human Services Secretary Dr. Tom Price also emphasised the administration’s stance that Obamacare is “failing” and should be done away with immediately.
Trump has repeatedly switched his position on the future of Obamacare, however, and the timing of it. He has both called for the law to stay so it can “implode,” and he has also urged congressional Republicans to repeal it and replace it with an alternative.
When asked on ABC’s “This Week” about Trump’s wavering opinions on Obamacare, Price said the president was concerned about “getting this moved in the right direction.”
‘Are you going to help it implode or try to fix it?’
But the Senate, in its current position, is unlikely to arrive at a compromise unless both sides make concessions, including opposing factions within the Republican party itself.
Majority leader Mitch McConnell’s third attempt to overhaul the healthcare system failed earlier this week, when three Republican Senators defected from the party, joining all 48 members of the Democratic caucus in voting against the so-called “skinny” repeal of Obamacare.
One of those Republican Senators, Susan Collins of Maine, told Jake Tapper that “the ball is really in our court right now” when it comes to delivering a more stable insurance system for the American people.
Collins, who opposed the GOP’s effort to repeal Obamacare because of its deep cuts to Medicaid and defunding of Planned Parenthood, acknowledged that the ACA has “serious problems” as it currently stands.
“So our job is not done … We need to go back to committee, to the Health Committee, and the Finance Committee, identify the problems, carefully evaluate possible solutions through hearings, and then produce a series of bills to correct these problems, the most serious of which is the pending collapse of the insurance markets,” Collins said.
She added: “And I certainly hope the administration does not do anything in the meantime to hasten that collapse.”
“This Week” host Martha Raddatz pointed that possibility out to Price, saying that the department he heads has the power to internally undermine Obamacare by stopping cost-sharing payments to insurers and not enforcing the individual mandate.
“So are you going to help it implode or try to fix it?” Raddatz asked Price.
Price responded by criticising Obamacare as it currently stands and said the HHS would “look at every single one” of the law’s rules and regulations to determine whether they drive up costs and “hurt patients.”
“And when it drives up costs and hurts patients, we’re going to move in the other direction,” Price said.
Raddatz again touched on Trump’s comments about allowing the Affordable Care Act to collapse. “Is what the president is proposing, letting the existing system fail, putting the needs of patients first?” Raddatz asked Price.
“The system has failed,” Price said. “That’s what the president’s saying, and that’s why he is demanding that Congress act.”
Tapper also asked Collins about Trump’s tweets threatening to end “bailouts” for members of Congress and insurers.
Collins said that while Trump’s threats would not affect her vote on healthcare reform, “it’s an example of why we need to act to make sure that those payments, which are not an insurance company bailout, but rather help people who are very low-income, afford their out-of-pocket costs towards their deductibles and their co-pays.”
In the end, she said, cutting off bailouts would not hurt insurance companies themselves as much as “some of the most vulnerable citizens” whose care could be affected.
“We’re talking about low-income Americans who would be devastated if those payments were cut off, though the threat to cut off those payments has contributed to the instability in the insurance market,” Collins added.
Mulvaney said that Trump’s tweets aimed at insurance companies and members of Congress were done in an effort to hold lawmakers accountable for their actions — or lack thereof — on healthcare reform.
“What he’s saying is, look, if Obamacare is hurting people — and it is — then why shouldn’t it hurt insurance companies and, more important perhaps for this discussion, members of Congress?” Mulvaney told Tapper. “There is a certain benefit that members of Congress get as part of an OPM decision from a couple of years ago. And I think the president is simply looking at this and going, is this fair?”
He added that Trump’s tweets were an approach to oblige congressional lawmakers to follow “the exact law that the folks that they govern are following.”
Working with Democrats
Regardless of the outcome, Republicans seem to be coming to the realisation that they will need to work across the aisle to move forward on healthcare.
Indeed, Georgia Republican Sen. David Perdue approached Democratic Sen. Chris Murphy shortly after Senate Republicans’ effort to enact a “skinny” repeal of Obamacare failed earlier this week.
“You ready to work together, Chris?” Perdue asked.
“You bet,” Murphy replied.
Democratic Sen. Bernie Sanders, who has long favoured a single-payer healthcare system, told Tapper on Sunday that he was putting the finishing touches on legislation proposing just that.
Sanders said there should be a government-funded health insurance option in every state.
“If people don’t like the private insurance that they’re getting, they should have a Medicare-type public option available in every state in this country,” Sanders said.
When Tapper asked him whether he would be submitting his legislation proposing a single-payer system, Sanders replied, “Absolutely, of course we are.”