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The day after the latest Republican healthcare bill collapsed, President Donald Trump laid out a few potential paths forward on healthcare for the federal government.
During a question-and-answer session with reporters on the lawn of the White House, Trump suggested a few things: that Republicans have enough votes to go it alone on repealing the Affordable Care Act; that he could work with Democrats to pass a bill by early 2018; and that he could issue executive orders within weeks to make unilateral changes to the system.
Trump repeatedly claimed Wednesday that Republicans had enough votes to pass a healthcare bill, which flew in the face of what the bill’s actual authors and GOP leaders said when they pulled the bill from a planned floor vote the day before. Trump blamed a Friday deadline for why it would have to be pushed back to January or February.
“We have the votes, but we can’t go longer than Friday,” Trump said.
Republicans’ ability, at least for awhile, to use the budget reconciliation process to pass a bill without the threat of a Democratic filibuster expires September 30. They will have to pass a new budget resolution with new reconciliation rules, but the Republican pivot to tax reform would complicate any plans to move a healthcare bill.
Then Trump suggested a possible bipartisan push to solve the issue with Democrats.
“I’m also going to meet with Democrats and see if we can get a health care plan that’s even better,” said the president. “So I will negotiate with Democrats.”
It’s unclear what sort of plan Trump would seek with Democrats. It could be simply a stabilization package for the Obamacare exchanges, similar to one that was being developed by GOP Sen. Lamar Alexander and Democratic Sen. Patty Murray – before Republican leaders scrapped the plan. It could also be a broader package to help correct some of the issues with Obamacare.
Finally, Trump said he was considering signing an executive order that he said would allow people to purchase insurance across state lines.
“I am considering an executive order on associations and that will take care of a tremendous number of people when it comes to healthcare,” Trump said. “And I’ll probably be signing a very major executive order where people can go out, cross state lines, do lots of things, and buy their own healthcare. And that will be probably signed next week, it’s being finished now.”
Allowing insurance to be sold across state lines has long been a focus for Trump. But Obamacare already allows it, no insurers use it, and it would likely do little to bring down costs.
The other idea he mentioned would allow association health plans, which would permit employees at small businesses and other individuals to pool together to buy insurance at more favorable rates.
The plans would not be subject to Obamacare regulations, and experts say they could destabilize the rest of the individual insurance market.
“Potentially quite destabilizing if these non-compliant association plans could skim of healthy individuals and small businesses,” tweeted Larry Levitt, a senior vice president at the Kaiser Family Foundation, a nonpartisan health policy think tank.
Trump did not specify which of these three options he would pursue first, or if they would all work in conjunction.