WASHINGTON --- Two senators, one Democratic and one Republican, Tuesday tried to focus Congress' attention on how to protect or replace the Affordable Care Act.
Richard Durbin of Illinois and Bill Cassidy of Louisiana reminded their colleagues that consumers and healthcare industry groups are nervous about the uncertain future of the law and need to know how it will be improved or replaced.
“Hospital administrators in my state are worried,” Durbin said. If the ACA is repealed without a strong replacement, “downstate hospitals will be forced to close, and women in labor and injured farmers will have to drive a long way to get care. It's life and death.”
“The Affordable Care Act is not working in states like Arizona and Louisiana,” said Cassidy, who has co-sponsored a bill to allow states to decide whether to keep the ACA framework or shift to a new conservative model. “Let's give the power back to state capitals.”
But the attention of lawmakers and the news media was elsewhere, as the furor over President Donald Trump's sudden executive order barring refugees and immigrants from seven predominantly Islamic nations continued to boil.
The focus strayed even further from healthcare Tuesday night, when Trump announced he was nominating Neil Gorsuch , a 49-year-old staunch conservative, to fill the Supreme Court seat vacated by the death in early 2016 of conservative stalwart Antonin Scalia. Democrats already are signaling they will filibuster the nomination of Gorsuch, whose confirmation would give conservatives a 5-4 edge on the high court that could tilt its decisions on access to abortion and other healthcare issues.
House Speaker Paul Ryan said that his party's move to repeal Obamacare via an expedited budget reconciliation bill will be delayed until March or April, and that a replacement package may not be passed until late this year. Senate Majority Leader Mitch McConnell expressed fears that an extended healthcare battle could swamp other GOP priorities such as tax reform.
But the domestic and international shock waves over Trump's immigration order now have eclipsed the healthcare issue, as was obvious on Capitol Hill Tuesday.
Throughout the day, Democratic lawmakers took turns blasting Trump's immigration order -- and his firing of the acting attorney general who refused to legally support it -- as unconstitutional and abusive. Republicans fired back, defending Trump's actions and accusing the Democrats of engaging in irresponsible political theater and obstructionism.
Meanwhile, the Trump administration and congressional Republicans grew increasingly anxious about not having a health policy leader in place to lead their ACA replacement effort. Democrats Tuesday blocked action on moving forward with the nomination of Rep. Tom Price as HHS Secretary.
Democrats cited a new Wall Street Journal report that Price did not tell the truth to the Senate Finance Committee that he received a preferential discounted offer of stock from an Australian biotechnology company.
Based on that report, they boycotted Tuesday's Finance Committee hearing, leaving the panel short of a quorum to vote to send Price's nomination to the full Senate. They are demanding more information about Price's healthcare-related stock deals before deciding on his nomination.
A spokeswoman for Finance Committee chairman Orrin Hatch said the Democrats' action “delays progress on working out reforms to Obamacare and the nation's failing healthcare system.” Hatch will continue to reconvene the committee “until Democrats show up, do their job, and vote.”
But Republicans could decide to move Price's nomination without Finance Committee approval to the full Senate, where they could confirm him on a straight party-line vote.
Earlier in the day, Ryan reiterated his party's determination to erase the ACA and replace it with something better. He argued the law is “collapsing” and people are struggling with high deductibles and lack of healthcare choice. The GOP alternative would “restore real competition,” he added.
Republicans are facing growing pressure from insurers and other healthcare industry groups to take action to stabilize the individual insurance market and maintain the current level of coverage while they work on repealing and replacing the ACA. Aetna CEO Mark Bertolini said Tuesday that Aetna may not participate in the ACA exchange market in 2018 due to the “unclear nature of where regulation is heading.”
On Wednesday, the Senate HELP Committee will discuss market stabilization issues. And on Thursday, the House Energy and Commerce subcommittee on health will consider four bills to make changes insurers say are needed to keep them in the market. The legislation would have to pass quickly to allow insurers time to factor the changes into their decisions whether to offer plans in 2018 and how to price them. They have to file their plan offerings and rates by spring.
Some experts think the House bills could draw enough Democratic support to pass. But the intense partisan conflict over Trump's immigration order and Supreme Court nomination could get in the way of any cooperative action on healthcare.