Governors back bipartisan Senate bid to control health costs

A group of Republican and Democratic governors became the latest voices Thursday to endorse a bipartisan Senate drive to control health insurance costs, in defiance of President Donald Trump.

Trump has threatened to block federal subsidies to insurers for lowering deductibles and other out-of-pocket costs for millions of lower-earning customers, calling them bailouts for insurance companies. Leaders of the Senate Health, Education, Labor and Pensions Committee are trying to quickly write legislation that would continue those payments for a year or more. Analysts and the insurance industry say halting the payments would spur new premium increases.

The support from the governors seemed to further isolate Trump on the issue. But with partisan feelings heightened by the failed Republican effort to dismantle former President Barack Obama's health law, the prospects for even a modest effort to shore up the Affordable Care Act are uncertain.

Health panel chairman Lamar Alexander, R-Tenn., said in a brief interview it was "a good bet" the narrow measure would be limited to extending the payments to insurers and making it easier for states to get exemptions to some of the statute's requirements.

"The more we try to do, the less likely we are to succeed" because of opposition, Alexander said.

In testimony Thursday to the health committee, three Republican and two Democratic governors backed continuing those payments. Most said they should be extended for at least two years.

Gov. Gary Herbert, R-Utah, said abruptly ending those subsidies would "destabilize" his state's markets where individual coverage is sold. Gov. Steve Bullock, D-Mont., said extending the payments for at least two years would be "the most important step" lawmakers could take to curb premiums and keep insurers from abandoning some markets.

The governors also backed more state flexibility to decide coverage requirements and federal aid to help insurers afford high-cost customers with serious conditions.

Alexander and the committee's top Democrat, Sen. Patty Murray of Washington state, are aiming their work at the individual insurance market, where 18 million people who don't get coverage at work or through government programs purchase policies. Those markets are expected to see premium increases averaging at least 25 percent next year.

Their work comes as Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., seek support for a long-shot GOP attempt to roll back much of Obama's law. Their proposal would turn much of the money spent under Obama's overhaul into block grants that states could use with wide latitude, cut Medicaid and end Obama's penalty on people who don't purchase coverage.

The measure has drawn support from Trump and Vice President Mike Pence, Cassidy said. But the GOP effort to repeal Obama's law loses its protection against Democratic filibusters on Oct. 1, meaning Republicans would need 60 votes to prevail — including an unattainable eight Democrats. Even with that protection, GOP leaders have fallen short of the 50 votes they've needed to win and would likely do so again.

Even Republicans expressed little optimism for the Cassidy-Graham effort.

"We'll consider it, but as we saw, this isn't easy" to get 50 votes, said No. 2 Senate GOP leader John Cornyn of Texas. "And everybody's kind of got another idea. But I'm open to it."