McConnell says GOP must shore up ACA insurance markets if Senate bill dies – Washington Post

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(Jenny Starrs/The Washington Post)

Senate Majority Leader Mitch McConnell (R-Ky.) said Thursday that if his party fails to muster 50 votes for its plan to rewrite the Affordable Care Act, it will have no choice but to draft a more modest bill with Democrats to support the law’s existing insurance markets.

The remarks, made at a Rotary Club lunch in Glasgow, Ky., represent a significant shift for the veteran legislator. While he had raised the idea last week that Republicans may have to turn to Democrats if they cannot pass their own bill, his words mark the first time he has explicitly raised the prospect of shoring up the ACA.

“If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,” McConnell said. “No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.”

McConnell, who pledged in 2014 to eradicate the law also known as Obamacare “root and branch,” initially raised the prospect of having to work with Democrats last week after he pulled a measure he had crafted behind closed doors. That bill would jettison the ACA’s requirement that most individuals prove they have health coverage, would repeal or delay billions in taxes imposed under the current law and would make deep, long-term cuts to the nation’s Medicaid program.

But while he previously declared that Republicans “need to come up with a solution” if they wanted to make real changes to the nation’s health-care system, McConnell on Thursday acknowledged how difficult it is proving to craft an alternative that can satisfy the GOP’s conservative and centrist camps.

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His suggestion that he and his colleagues might instead try to bolster the insurance exchanges created under the ACA is at odds with Republican talking points that they are beyond repair. The marketplaces were built for people who do not have access to affordable coverage through a job, and at last count slightly more than 10 million Americans had health plans purchased through the exchanges. More than 8 in 10 customers bought their plans with federal subsidies the law provides.

Until now, both congressional Republicans and the Trump administration have contended that the “collapse” of the ACA marketplaces is a main reason to erase much of the 2010 law.

McConnell said Thursday in Glasgow that he continues to “twist the dial” to build support for his legislation. But with no Democrats willing to back it, he can lose no more than two of his 52 caucus members. Vice President Pence would then cast the tiebreaking vote.

A spokesman said Thursday evening that there was “literally” no difference between McConnell’s remarks this week and last week, when he said that “either Republicans will agree and change the status quo, or the markets will continue to collapse and we’ll have to sit down” with Democrats.

“Both times he was talking about passing something,” Don Stewart said. “His point was: The only way Democrats would work with us is [to] prop up Obamacare, not fix it.”

Yet the Fourth of July recess has not bolstered the political prospects for McConnell’s legislation; GOP senators have been peppered with questions by constituents anxious about the potential impact on their coverage. In the past several days, some senators have implied that considerable work would still be required before the Better Care Reconciliation Act could pass the Senate.

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