Oct 8, 2017

Can Trump and Schumer really make a health care deal?

Trump in the Rose Garden after the House passed a health care plan in May. Photo: Evan Vucci / AP

So what to make of Trump's next turn on health care? Axios scooped on Friday night that Trump had called Democratic Senate Leader Chuck Schumer to see whether they could cut a deal. Now Trump and Schumer are giving their versions of the call.

Here's our best forecast of where this conversation is headed and why it's likely to explode politically:

  • If there's another Trump-Schumer conversation — and this isn't just a one-off — the president has to figure out if he really wants to take repeal off the table. If he does, the GOP base blows up. But if he doesn't, it's not surprising that Schumer calls it a nonstarter.
  • Even if Trump did decide to take repeal off the table, and just stabilize the Affordable Care Act, there's nothing remotely easy about reaching a health care deal with the Democrats. Republicans would have to get something out of it.
  • At a minimum, Republicans want states to be able to cut back the ACA's rules on what has to be covered. They think that's the key to making health insurance less expensive. But for Democrats, that's just a backdoor way of undermining coverage of pre-existing conditions.
  • Example: If they let states cover fewer benefits — like, say, not making them cover prescription drugs — then those are benefits that sick people won't get. So even if you say people with pre-existing conditions are still covered, they wouldn't have as much coverage as they do now. Democrats will be under a lot of pressure to oppose that.
  • This is where senators Lamar Alexander and Patty Murray are stuck in trying to negotiate their deal. Murray has offered smaller concessions, but nothing that would interest most Republicans.

Bottom line: If Alexander and Murray can't get past that roadblock — two people who really know the details of the health care law — how is Trump going to cut his own deal with Schumer, since policy details aren't really his thing?

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