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24 hours later, Senate health deal all but completely dead

24 hours later, Senate health deal all but completely dead
© Greg Nash

A Senate healthcare deal to extend critical ObamaCare payments to insurers appears all but completely dead just 24 hours after it was announced.

President Trump reversed course Wednesday and said he opposed the deal, while Speaker Paul RyanPaul Davis RyanBiden's relationship with top House Republican is frosty The Hill's Morning Report - Presented by Emergent BioSolutions - Facebook upholds Trump ban; GOP leaders back Stefanik to replace Cheney Budowsky: Liz Cheney vs. conservatives in name only MORE’s (R-Wis.) office said the Senate should keep its focus on repealing and replacing President Obama’s signature law.

Sen. John ThuneJohn Randolph ThuneGOP split on counteroffer to Biden's spending Senate GOP dismayed by vote to boot Cheney Top Democrat: FCC actions are a 'potential setback' to autonomous vehicles MORE (S.D.), the third-ranking Senate Republican, acknowledged the deal had “stalled out.”

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Some Republican senators said they were working on changes to move the bill in a more conservative direction, but those efforts appeared to have little chance of success.

Democrats, who hailed the agreement on Tuesday, signaled they were preparing to blame Republicans for walking away from the deal crafted by Health Committee Chairman Lamar AlexanderLamar AlexanderThe Republicans' deep dive into nativism Senate GOP faces retirement brain drain The Hill's Morning Report - Presented by the National Shooting Sports Foundation - CDC news on gatherings a step toward normality MORE (R-Tenn.) and Sen. Patty MurrayPatricia (Patty) Lynn MurrayBiden's pre-K plan is a bipartisan opportunity to serve the nation's children Schumer 'exploring' passing immigration unilaterally if talks unravel Senate Democrats push Biden over raising refugee cap MORE (Wash.), the panel’s top Democrat.

“Lamar and Patty came up with a deal,” Senate Democratic Leader Charles SchumerChuck SchumerBiden 'encouraged' by meeting with congressional leaders on infrastructure Republicans welcome the chance to work with Democrats on a bipartisan infrastructure bill Cheney sideshow distracts from important battle over Democrats' partisan voting bill MORE (N.Y.) told reporters. “This is the agreement.”

The compromise would provide two years of payments to insurers, compensating them for lowering the out-of-pocket health care costs of certain ObamaCare enrollees. Trump announced he was canceling the payments last week, arguing the previous administration lacked the authority to make them.

Without the payments, the Congressional Budget Office has said premiums could rise as much as 20 percent, and enrollment would likely fall.

Democrats say Trump is seeking to sabotage the law by ending the payments, along with other administrative moves he’s made that they say could damage ObamaCare.

The Alexander-Murray language would also grant states more flexibility to waive ObamaCare rules, a key Republican ask. Lower-cost insurance plans that provide fewer benefits, known as copper plans, would be allowed.

In a nod to Democratic demands, it would provide states with $106 million to fund ObamaCare outreach. Trump had slashed the money for advertising by 90 percent. 

Conservatives have called the payments to insurers a bailout, an argument echoed by Trump on Wednesday.

In response, Alexander said that he was open to adding any language the White House might have to strengthen a provision already in the bill to ensure that insurers can’t keep the payments for themselves, but rather have to pass savings on to consumers in the form of rebates or another mechanism.   

Alexander has been trying to rally support by warning Republicans that premiums would increase 20 percent without the insurer payments and there would be chaos in the market. There’s not much time left, as ObamaCare’s exchanges open for business Nov. 1. 

Sen. Ron JohnsonRonald (Ron) Harold JohnsonImmigration experts say GOP senators questioned DHS secretary with misleading chart GOP split on counteroffer to Biden's spending Rand Paul clashes with Fauci over coronavirus origins MORE (R-Wis.) said he is pushing for more sweeping changes to move the bill to the right, and has spoken with Alexander. 

Johnson is seeking to increase the duration of short-term health plans; expand health savings accounts; not enforce the employer mandate; and waive the individual mandate penalty for 2017. 

Johnson argues he’s working to shore up conservative support in the House.

“[Alexander and I] are both interested in getting a result,” Johnson told reporters Wednesday. “He's dealing with the hurdle of the Senate. I'm trying, to some extent, to deal with the hurdle in the House and maybe both of our efforts can come together and show members of Congress that this is what we're going to need to do to really alleviate the increasing premiums, which are going to hurt Americans.”

It seems unlikely that Democrats will agree to any of those demands, however.

Schumer blasted Trump for reversing course after the president had previously made phone calls to Alexander encouraging the talks. He warned that ObamaCare was becoming TrumpCare given the administration’s actions, and that the GOP would own it.

“The president's in charge,” Schumer said. “Republicans have the House and Senate. If there's problems in the healthcare system, it falls on their shoulders.” 

Many observers think folding the deal into a government funding bill in December is its best chance of passage. Schumer said that is one option, though he held out hope the agreement could pass before then. 

Only a handful of Republicans, Sens. Lisa MurkowskiLisa Ann MurkowskiSenate panel deadlocks over Biden pick to lead DOJ civil rights division Senate GOP dismayed by vote to boot Cheney Cheney set to be face of anti-Trump GOP MORE (Alaska), Mike RoundsMike RoundsGOP split on counteroffer to Biden's spending Democrats, GOP agree on one thing: They're skeptical of a deal Senate GOP keeps symbolic earmark ban MORE (S.D.), John McCainJohn Sidney McCainRepublicans have dumped Reagan for Trump The Hill's Morning Report - Presented by Facebook - Cheney poised to be ousted; Biden to host big meeting Cheney set to be face of anti-Trump GOP MORE (Ariz.) and Bob CorkerRobert (Bob) Phillips CorkerCheney set to be face of anti-Trump GOP How leaving Afghanistan cancels our post-9/11 use of force The unflappable Liz Cheney: Why Trump Republicans have struggled to crush her  MORE (Tenn.), have said they support the deal. Murkowski and McCain voted against the a scaled-down ObamaCare repeal bill in July, helping to sink the measure. 

“Obviously until the president’s on board, yes there are probably changes that need to be made to satisfy the president,” Sen. John CornynJohn CornynGOP split on counteroffer to Biden's spending Police reform talks hit familiar stumbling block CNN asks Carol Baskin to comment on loose Texas tiger MORE (R-Texas), the No. 2 Republican, said. “I think the president's support is going to be key.”