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House Speaker Paul Ryan opposes short-term Obamacare fix proposed in Senate

Dan Mangan
Joshua Roberts | Reuters. U.S. stock futures were modestly lower this morning, as investors await details on the Senate's version of a tax reform bill.

The odds of passing a newly proposed bipartisan "short-term fix" for Obamacare got longer Wednesday as House Speaker Paul Ryan 's office indicated he opposes the bill — and as President Donald Trump 's spokeswoman said he does not support the legislation as now written. "The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare," said Doug Andres, spokesman for the Wisconsin Republican Ryan. If Ryan holds firm in that opposition, it could doom the bill since it would need to pass the House, in addition to the Senate to be sent to Trump for signing. Trump's spokeswoman, Sarah Huckabee Sanders, said the president does not support the bill as currently written. Tweet Senate Minority Leader Chuck Schumer, D-NY, said that the Alexander-Murray bill would easily pass the Senate, with up to 10 Republican co-sponsors, if a vote is held. Schumer also revealed Wednesday that the bill, if it becomes law, would extend the enrollment period for Obamacare plans for 2018 by 30 extra days. Currently, open enrollment in those individual health plans is set to run from Nov. 1 through Dec. 15. Despite Schumer's optimism for the bill, in the Senate at least, Sen. John Thune, R-S.D., said the bill may be "stalled," and called its future an "open question." A draft of the bill obtained by National Public Radio on Wednesday would require insurers to give customers a one-time or monthly rebate out of funds the government would release to the halth plans If the rebates were not given, the money would have to be refunded to the government. That provision could assuage concerns by Trump that the bill would "bail out" insurers. Trump has sent decidedly mixed signals on the tentantive deal for a series of measures to prop up Obamacare markets announced Tuesday by Sen. Lamar Alexander , R-Tenn., and Patty Murray , D-Wash. Among other things, the bill would reinstate billions of dollars in federal reimbursement payments to Obamacare insurers, which Trump ceased last Thursday. Prices of many Obamacare insurance plans will be much higher than they otherwise would have been in 2018 because of Trump's long-time threats to kill those payments, and because of his follow through on those threats. The payments compensate insurers for discounts in out-of-pocket health costs insurers give low-income customers. The draft of the bill that came to light Wedneday apparently, with its rebate provision, seeks to address concerns that insurers who had raised their rates because of the expected lack of the payments would get a financial windfall if the so-called cost-sharing reduction reimbursements were restored. In addition to funding the CSR payments, the bill would give states flexibility in what kinds of insurance plans could be sold in individual states, provide extra money for Obamacare enrollment outreach, and allow people of all ages to enroll in lower-cost, less-generous catastrophic health plans. During an interview with Axios on Wednesday, Alexander said he had just finished a phone conversation with Trump. He said the president had called him to encourage him about the deal with Murray. "Trump completely engineered the plan that we announced yesterday," Alexander said. He added Trump called him repeatedly, and asked that Murray be part of it. "He wanted a bipartisan bill for the short term," Alexander told Axios. Alexander said Trump told him that he needed to review the proposal to "reserve his options." But shortly after Alexander spoke, Trump posted a message on Twitter that attacked a key component of the bill — the funding of cost-sharing reduction payments to insurers. Tweet "I won't do anything to enrich the insurance companies," Trump told reporters at the White House. Alexander responded to Trump's message on Twitter, saying Trump had phoned him again. Tweet Tweet Alexander later elaborated on Trump's involvement, telling reporters: "The president called me 10 days ago and asked me to work with Senator Murray to do this." That was about a week before Trump killed the CSR payments that the deal is designed to restore. "He called me last Saturday we talked about it, he called me this morning," Alexander said. "He still wants a block grant proposal," Alexander said, referring to a Senate bill that would give states flat sums of money to subsidize individual insurance market coverage for individuals and Medicaid. "I think everybody in the country understands that. But that's not going to come this year and he understands there's an interim gap and it's better served by a bipartisan bill like this," Alexander said. When asked if Trump told him that he could support the deal without the block-grant provision, Alexander said, "Well he hasn't said that and I wouldn't expect him to." "He encouraged me to get an agreement with Senator Murray. He said he would review it. That's all I could ask a president to do." Alexander then was asked if he could get the bill passed without Trump's support. "Well I can certainly introduce it," Alexander said. "You know the legislative process is steps, and Step 1 is an agreement. Senator Murray and I now have that. Step 2 is to have several Republican and Democrat co-sponsors and we'll have those by Thursday." "And then Step 3 will be to work with the White House, work with the House, and see how to pass it," Alexander said. "I would predict that for the end of the year, this agreement, in one form or the other, will become law."

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