Trump should back the bipartisan ACA effort

Sen. Patty Murray, D-Wash., the ranking member of the Senate Health, Education, Labor, and Pensions Committee, talks to reporters on Capitol Hill on Oct. 18.
Carolyn Kaster/Associated Press
Sen. Patty Murray, D-Wash., the ranking member of the Senate Health, Education, Labor, and Pensions Committee, talks to reporters on Capitol Hill on Oct. 18.

After several days of mixed messages, President Donald Trump has a crucial decision to make about whether to support a Senate deal to shore up the Affordable Care Act. The responsible course is clear. Even if the president eventually plans to renew his ill-fated attempt to repeal the law, he should back Senate efforts to bolster the ACA’s insurance markets in the short term.

Until this week, Trump has seemed intent on undermining Obamacare, his predecessor’s signal legacy. He has repeatedly and falsely claimed the law is failing. Actually, as both the Congressional Budget Office and Standard & Poor’s have noted, the law’s individual insurance markets are stabilizing.

Last week, the administration declared it would no longer make cost-sharing reduction payments that lower deductibles, copayments, and other out-of-pocket expenses for many who purchase insurance on the ACA’s exchanges. Those payments, of about $7 billion, have benefited more than 6 million people, including some 80,000 in Massachusetts.


Shortly after that announcement, Trump tweeted that the law is “a broken mess” and said that Democrats “should call me to fix.” On Monday, he tried again to bump Obamacare into the abyss, declaring the ACA dead and gone and saying: “There is no such thing as Obamacare anymore.”

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Imagine the surprise, then, when on Tuesday Trump expressed support for an agreement hammered out between Republican Senator Lamar Alexander and Democrat Patty Murray to continue those payments in exchange for giving states more latitude in health plan offerings. And when Alexander asserted that Trump had encouraged him to work out such a deal.

Since then, however, Trump has walked — or rather tweeted — back his support:

For his part, Alexander has shrewdly used that tweet to underscore that the agreement doesn’t help insurance companies, but rather those who buy policies on the insurance exchanges. He’s also offered to work with the president to guarantee that that’s the case.

Trump should take the Tennessee senator up on that face-saving offer. Having repeatedly failed at ACA repeal, a wise president would cut his losses and direct his attention and that of his party to other issues. Given that Trump and the GOP seem unwilling to do that, this agreement preserves their political options.


It is a short-term deal, and thus would allow the GOP to campaign on ACA repeal through yet another congressional election cycle. If the majority party chooses to go that route, the 2018 midterms will give voters a chance to weigh in on that matter.

Until then, the right course for the president is to make the individual insurance markets work for those Americans who depend on them. If he doesn’t, the blame for future ACA turmoil and the pain that results should reside squarely with the president and his party.