On Wednesday afternoon, Sens. Susan Collins (R-ME) and Lamar Alexander (R-TN) announced they would postpone until the New Year their request for considering an Obamacare “stability” bill. Their statement capped a sequence of developments that raised almost as many questions as it answered—about the “stability” bill, the process used to consider it, and Obamacare itself.
1. If Congress Just ‘Essentially’ Repealed Obamacare, Why Pass a Bill to Prop It Up?
Ahead of final passage of the tax bill on Wednesday, President Trump claimed at a cabinet meeting that “when the individual mandate is being repealed” in the tax bill, “that means Obamacare is being repealed. We have essentially repealed Obamacare.”
The administration undermined the president’s own case later that day, however, when unnamed White House officials said they would work to pass the “stability” bill Collins and Alexander support. The two senators envision appropriating tens of billions of taxpayer dollars to health insurers in two forms—reinsurance payments, and cost-sharing reduction reimbursements—both of which would bolster rather than undermine the Obamacare exchanges.
The president overstated his case, of course. Congress has not repealed the law, nor has it repealed the “heart” of the law, as Sen. Mitch McConnell claimed on Thursday—and the debate on the “stability” bill explains why. The heart of Obamacare rests in its insurance regulations, all of which remain in place following the mandate’s repeal. Without the individual mandate—designed to compel healthy individuals to purchase government-required health coverage, thereby subsidizing the sick—premiums could increase.
Collins and Alexander wish to “solve” this problem not by repealing Obamacare’s insurance regulations—which would lower premiums and increase health care choices—but instead by throwing tens of billions of taxpayer dollars at the problem through the “stability” bill.
2. Why Did Susan Collins Ever Assume Mitch McConnell Spoke for Congress?
Reporters have raised numerous questions—to which Collins has taken offense—about whether Maine’s senior senator was “duped” into supporting repeal of the mandate in the tax bill in exchange for Sen. Mitch McConnell’s support of the “stability” measure. And with good reason. Enactment of the “stability” bill would require 1) at least 60 votes in the Senate to overcome a possible filibuster and 2) consent of Speaker Paul Ryan (R-WI) and House Republican leadership to bring it to the floor for a vote. Under no circumstance does either lie solely within McConnell’s gift.
Particularly given the major implications of the “stability” bill on federal funding of abortion coverage, Collins had no reason to assume McConnell could deliver anything other than a Senate floor vote on the “stability” measure. If McConnell promised more than that, he put his own reputation in jeopardy, because he promised something he could not deliver.
And if Collins, having served in the Senate for more than two decades, believed that the Senate majority leader could single-handedly determine whether the “stability” bill got enacted into law, let’s just say I have some land to sell her.
3. Does the White House Support Federal Funding of Abortion Coverage, Or Not?
Wednesday’s statement of support for the “stability” bill by the unnamed White House official—why won’t anyone in the White House go on-the-record about this legislation?—said nothing about one of the main controversies surrounding the measure: Whether it will contain strong pro-life protections. The White House has not indicated whether it has conditioned its support for a “stability” bill on inclusion of pro-life funding language, thus opening the possibility that President Trump will sign a bill including tens of billions in taxpayer funding for plans that cover abortion.
Republicans have argued for seven years that any executive order—whether issued by President Obama, President Trump, or any president—cannot adequately protect federal tax dollars from flowing to plans that cover abortion. When coupled with its endorsement of Obamacare “stability” legislation, the White House’s deafening silence on the life issue speaks volumes. Conservatives have numerous reasons to worry, for a “stability” bill that bolsters both Obamacare and abortion would represent a twofold violation of long and deeply held principles.
Mr. Jacobs is founder and CEO of Juniper Research Group, a policy consulting firm based in Washington. He is on Twitter: @chrisjacobsHC.