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Will Trump Derail a Popular Obamacare Deal That Would Slash the Deficit and Stabilize Coverage?

A bipartisan Obamacare deal struck by Senate health committee leaders Sen. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.) would keep the number of insured Americans level, premiums on a stable course, and cut the federal budget deficit by $3.8 billion over the next decade, according to a new report. But the legislation may never even come to a vote—despite amassing a pile of Senate co-sponsors from both sides of the aisle—without a strong signal from an unpredictable source: President Donald Trump.

The Alexander-Murray bill, called the Bipartisan Health Care Stabilization Act of 2017, is essentially a legislative band-aid meant to shore up Obamacare markets in the near term by guaranteeing health insurer subsidies that Trump recently decided to cut off after months of threats. (A federal judge just rejected a bid by 18 attorneys general to force the administration to make the payments, which are used to lower poorer Americans’ out-of-pocket medical costs). It would also set aside a formidable amount of money for Obamacare outreach programs (funding that the Trump Administration has also pulled back, likely hitting enrollment numbers), as the nonpartisan Congressional Budget Office (CBO) explains in a new analysis released Wednesday. Furthermore, the Alexander-Murray bill lets all Americans in the individual insurance markets buy bare-bones “catastrophic” health plans that are currently limited to people under the age of 30 or those who have some kind of financial hardship.

The latter is a policy heavily backed by conservatives who argue Americans of any age should have access to skimpier plans, which have lower premiums but much higher deductibles, if they so chose. An influx of new customers buying such policies could potentially lower premiums across the board for Obamacare plans. This measure alone would save the federal government more than a billion dollars in 10 years, according to the CBO score. Coverage levels and premiums would not change significantly compared with current law (i.e., Obamacare), as opposed to other health care legislation proposed by Congressional Republicans in recent months that have been projected to significantly hike premiums and the number of uninsured Americans by CBO and other independent groups.

Alexander and Murray have racked up at least 24 co-sponsors in the Senate for their Obamacare bill, including Republicans Lindsey Graham, Bill Cassidy, Susan Collins, and John McCain, and Democrats Jeanne Shaheen, Al Franken, Joe Manchin, and Claire McCaskill. But Senate Majority Leader Mitch McConnell has signaled he won’t bring it up for debate until Trump gives him a clearer idea of what he’s seeking from Congress on health care. “Well, what I’m waiting [for] is to hear from President Trump what kind of health care bill he might sign,” McConnell told CNN on Sunday. House Speaker Paul Ryan indicated Wednesday that lawmakers won’t debate the issue again until 2018.

What Trump will do in the coming weeks is anyone’s guess. After a series of aggressive actions undermining various Obamacare requirements and funding this month—including cutting off the Obamacare subsidies—Trump initially seemed supportive of the bipartisan Alexander-Murray approach. But he then reversed course a day later and slammed the insurer payments as “bailouts” he could never support. Meanwhile, the GOP-controlled Congress would be loath to debate and potentially pass a health care fix crafted with Democrats without an ironclad assurance that Trump will sign it into law. It’s one they may not get anytime soon.