Oct 18, 2017

Trump’s mixed signals on health care deal

Trump met with Senate Finance Committee chairman Orrin Hatch and other committee members this morning. Photo: Susan Walsh / AP

White House press secretary Sarah Huckabee Sanders now says President Trump doesn't support the bipartisan Senate health care deal in its current form. That should settle questions about his position for now, but that's after 24 hours of mixed signals that left some of his own advisers unclear where he really stands, as recently as this morning.

What we're hearing: Before Sanders' briefing this afternoon, a senior administration official told us that everyone is hearing what they want to hear, and nobody knows exactly what Trump wants from hour to hour or where he will land. To some extent, his own advisers are never completely sure. But it's fair to say that everyone who is remotely conservative inside the administration is pushing not to keep funding the Affordable Care Act's insurer subsidies without serious concessions.

What's at stake: The deal by Sens. Lamar Alexander and Patty Murray would fund the insurer subsidies for two years, as well as the rest of this year, after Trump said he was going to cut them off. In exchange, states would get an easier waiver process so they don't have to follow all of the ACA coverage rules.

What Trump has said:

  • Yesterday, after meeting with the Greek prime minister: “it is a short-term solution so that we don't have this very dangerous little period — including dangerous periods for insurance companies, by the way ... For a period of one year, two years, we will have a very good solution. But we're going to have a great solution, ultimately, for health care."
  • Last night, in speech to the Heritage Foundation: "While I commend the bipartisan work done by Senators Alexander and Murray -- and I do commend it -- I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies."
  • This morning on Twitter, after Axios event with Alexander: "I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co's who have made a fortune w/ O'Care."
  • This morning, before a meeting with Senate Finance Committee members: "If something can happen, that's fine. But I won't do anything to enrich the insurance companies."

What Sanders said this afternoon: "A good step in the right direction," but “it's not a full approach, and we want something that goes a little bit farther."

Who's against the deal: House Speaker Paul Ryan — which would make it hard to get the bill through the House, even if it gets through the Senate. Office of Management and Budget director Mick Mulvaney has also said the administration wouldn't support an Alexander-Murray bill without big concessions.

Who's for it: It's clearly in Democrats' interests to keep the ACA markets from falling apart, but there's also significant support among Senate Republicans for stabilizing the markets, Sen. John Thune told Caitlin Owens yesterday.

Go deeper: Mike Allen on Trump's improvisational style.

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