Susan Collins says votes promised on bills to stabilize ACA won’t happen until 2018

11
The ACA bills backed by Sen. Susan Collins would slow premium increases and help health insurers stay in the individual marketplace. (AP Photo/J. Scott Applewhite)

Sen. Susan Collins announced Wednesday that crucial Affordable Care Act stabilization bills will be delayed until 2018 despite the promises she received from Republican leaders that they would be approved by the end of this year. Collins had emphasized passage of the two bills to secure her vote for the tax reform bill.

“I think the policy is more important than the deadline, and the deadline is slipping. And I am the first to say that I am not happy about that, that I’m disappointed about that,” Collins, a moderate Republican, told the Portland Press Herald in an interview Wednesday. “But I believe that at the end of the day, we’re going to end up where I want us to be – in fact, maybe even with a better bill.”

Progressives immediately attacked Collins, arguing that Maine’s senior senator is being bamboozled in a deal that Republican leadership never intended to keep.

“So much for those ‘ironclad promises,’ ” said Christina Foster of Peaks Island Indivisible, a liberal advocacy group. “I can’t tell if she got played, or if she’s playing us.”

As Congress was mulling tax reform, Senate Majority Leader Mitch McConnell had promised Collins in a Dec. 1 exchange on the Senate floor that the two ACA bills would be voted on “ideally” before the tax reform vote and “certainly” by the end of the year.

But hours after voting for the sweeping $1.5 trillion tax package Wednesday, Collins said in a written statement that she and Sen. Lamar Alexander, R-Tennessee, were voluntarily withdrawing the two ACA stabilization bills from consideration this year, and that the bills will be taken up by Congress next year.

Advertisement

Collins’ announcement came a day after she called media coverage of her support for the tax overhaul “unbelievably sexist,” citing a report that noted she didn’t cry after meeting with protesters who had grave medical conditions.

Collins opposed repealing the ACA’s individual mandate as part of the tax reform package without also passing laws to mitigate the harm that would do to insurance markets. Independent health policy analysts have said that – at a minimum – the bills, especially the Collins-Nelson reinsurance bill, would temporarily alleviate the blow to insurance markets caused by repealing the mandate.

The individual mandate – which requires people who don’t have coverage through an employer to purchase health insurance or pay a penalty – helps keep premiums down because it gets more young and healthy people into insurance pools.

Republicans added the mandate repeal into the tax reform bill this fall after previous attempts to repeal the entire ACA failed. This summer, Collins was one of three Republicans to buck her party, successfully saving the ACA in a dramatic vote in July, and she also helped deep-six another attempt in the early fall by announcing her opposition to full repeal.

Collins’ vote is sought after in a closely divided Senate, where Republicans have a 52-48 majority that will slip to 51-49 after Alabama Democrat Doug Jones is seated in January. Jones upset Republican Roy Moore in a Dec. 12 special election.

Collins – even though she spoke against adding ACA individual mandate repeal to tax reform – was in favor of the tax bill overall, saying it will boost the economy.

ASSURANCES FROM HOUSE SPEAKER RYAN

Conservative Republicans and President Trump have a long-stated goal of repealing the ACA, which was championed by former Democratic President Barack Obama.

Short of a full repeal, removing the individual mandate eliminates a key component of the law, a fact cheered by Trump and McConnell this week.

Collins, in the Press Herald interview Wednesday, contended that she still has commitments of support for the bills from McConnell, Trump and House Speaker Paul Ryan. Collins said she spoke with Ryan for 25 minutes Wednesday to shore up his support. Ryan made positive comments to her about the future of the bills, Collins said in her statement.

“(Wednesday) afternoon Speaker Paul Ryan called me and said that the House remains committed to passing legislation to provide for high-risk pools and other reinsurance mechanisms similar to the bipartisan legislation I have introduced,” Collins said. “He pointed out that by waiting until early next year, we will be able to use a new (Congressional Budget Office) baseline that will result in more funding being available for reinsurance programs that have been proven effective in lowering premiums while protecting people with pre-existing conditions like diabetes, heart disease and arthritis.”

Collins said Senate Democrats, by objecting to the bills being inserted into an end-of-year budget package, and conservative Republicans in the House, who have spoken up against the ACA bills, were both at fault for the delay of her bills.

“It’s both. There’s no doubt about it,” Collins said. “In the Senate, it was the Democrats. In the House, it was the Republicans. But my point is, I’m not giving up on this. These bills are too important.”

WHITE HOUSE REPORTEDLY BACKS ACA BILLS

Senate Minority Leader Chuck Schumer, D-N.Y., said in Nov. 15 statements on the Senate floor that repealing the mandate for the Alexander-Murray bill, which restores cost-sharing payments to insurers, is a “dark trade-off.”

“Any Republican senator who thinks they can (repeal) the individual mandate and then turn around and get Murray-Alexander passed is dead wrong. It is clear the dark trade-off at the center of the Republican policy agenda is back, cutting health care in order to fund tax giveaways to the very wealthy and very powerful. Democrats will not go for it,” Schumer said.

A Trump spokesperson, speaking on condition of anonymity, told the Politico website Wednesday that the White House is behind Collins’ efforts on the two ACA bills and is working with the House to make it happen.

“The president is grateful for the opportunity to work with Sen. Collins on this, and he is committed to following through on our agreement,” the senior White House official told Politico.

Collins and Alexander said in a written statement that the ACA bills would likely be taken up as part of a spending package early next year.

The tax reform bill, which was approved by the House and Senate this week and now awaits Trump’s signature to become law, is projected to increase the national debt by $1 trillion over 10 years even after accounting for economic growth generated by the tax cuts. It permanently slashes the corporate tax rate from 35 percent to 21 percent and reduces taxes for individuals for nine years.

Liberals have argued that the tax cuts are skewed heavily in favor of the wealthy and will harm the economy and the health care system, while conservatives point to business growth as a benefit of the bill.

SHIFTING STATEMENTS ON ACA BILL VOTES

Collins’ statements on the timing of the votes for the ACA stabilization bills have shifted over the past few weeks.

During a Christian Science Monitor breakfast in Washington on Nov. 30, she was widely quoted as saying she expected that the ACA bills would be voted on before tax reform.

“So I’m going to know whether those provisions made it and that matters hugely to me,” Collins said at the breakfast, according to The Hill newspaper.

In a Dec. 14 meeting with progressive activists at her Washington office, Collins said she used her leverage to extract promises from Republican leadership that the bills would be taken up by the end of 2017.

“What I’m telling you is I believe the commitments that I’ve received,” Collins told Ady Barkan, a health care activist who has ALS, according to video posted on Barkan’s twitter account. “I used my leverage to negotiate these agreements that are promises to me.”

Maine liberals were deeply skeptical, saying Collins lost her leverage after tax reform passed Wednesday.

Phil Bartlett, Maine Democratic Party chairman, slammed Collins for “broken promises” that will lead to instability in insurance markets and fewer people with health care coverage.

“Senator Collins can spin this massive mistake however she wants, but the simple truth is this: She broke her promise to the people of Maine and now they are once again left holding the bag,” Bartlett said in a written statement.

Rebecca London, with Protect Our Care, a progressive health advocacy group, said in a statement that Collins “failed to deliver on her promises, or never intended to.”

“After casting a vote for health care repeal in the middle of the night, Susan Collins finally admitted what everyone not in GOP leadership has been saying for months: That her promises weren’t worth the paper they were written on,” London said.

About 13 million fewer Americans would have health insurance if the mandate were repealed, and premiums would increase by 10 percent, according to the Congressional Budget Office.

Health policy experts have said the ACA stabilization bills – especially the Collins-Nelson bill that would pay for $10 billion in reinsurance over two years – would alleviate premium increases and help insurance companies stay in the individual marketplace. How much they would help depends on the analysis – some predict they would completely offset the premium increases, while others project more modest benefits.

Collins-Nelson provides funding for two years, so all analysts have concluded that the benefits from passing that bill end after two years.

Press Herald columnist Bill Nemitz contributed to this report.

Joe Lawlor can be contacted at 791-6376 or at:

jlawlor@pressherald.com

Twitter: joelawlorph

Advertisement