Next Phase for Health Care Reform Uncertain After Repeal is Defeated in Senate

With the dramatic failure of the Senate to pass a health care bill last week still fresh in people’s minds, lawmakers and the Trump administration are scrambling to determine their path forward. The House left town at the end of the week for their month-long recess, but the Senate will be in session for another two weeks. (Senator John McCain (R-AZ), who cast the deciding vote to defeat the final attempt at repeal, has headed back to his home state and does not plan to return to D.C. until September.) Despite Senate leadership not being able to put forward a plan that Republicans could rally around, President Trump said over the weekend that Congress looked “like fools” and should continue to push for a health care bill, changing the filibuster rules to require only a simple majority if necessary. He said they should not vote on anything else until they get another vote on the healthcare bill. 

 

Meanwhile, a bipartisan group of approximately 40 Representatives calling themselves the “Problem Solvers Caucus” have been meeting and plan to unveil legislation with fixes to the Affordable Care Act (ACA) soon. The plan focuses on stabilizing the individual insurance market, including by funding cost-sharing subsidies which have been a point of political contention for some time, most recently being characterized as a “bailout” for insurance companies by President Trump. The group of lawmakers is also planning to address the employer mandate by redefining “large employers” under the ACA to be those that have more than 500 workers rather than the current law’s 50. Some other fixes planned are to create a federal stability fund, repeal of the ACA’s medical-device tax, and creating greater flexibility for state innovation. 

 

On the Senate side, Sen. Lindsey Graham (R-SC) is attempting to rally support for a proposal to block grant federal health care funding (including notably Medicaid). Senators Dean Heller (R-NV) and Bill Cassidy (R-LA) have joined with Graham to push for this new alternative plan. Proponents are saying the bill will get a more favorable CBO score than other recent bills, and could be more palatable to lawmakers that did not support prior health care reform efforts. However, it’s a shaky path forward given the reluctance of leadership to open up the process for yet another bill that does not have the full backing of a majority of Members. The key takeaway is that health care reform efforts are not dead, but conversations are still occurring at all levels and among all the major players. When or if a new health care bill will be introduced remains an open question.