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Trump, McConnell float possibility of bipartisan action on health issues


Mitch McConnell

Democrats rode a wave of healthcare concerns to win back control of the House Tuesday night while Republicans tightened their grip on the Senate, a recipe for legislative gridlock unless lawmakers from both parties find a way to work together. | AP Photo/Pablo Martinez Monsivais

Health Care

11/07/2018 03:29 PM EST

Senate Majority Leader Mitch McConnell on Wednesday conceded that Democrat’s seizure of the House slams the door on Obamacare repeal efforts in Congress, but held out the possibility of unspecified bipartisan fixes to shore up the law’s insurance markets.

“I think it’s pretty obvious that a Democratic House is not going to be interested in that,” McConnell told reporters when asked about another run at abolishing the law. “There are serious problems with Obamacare, serious problems, that need to get fixed. … I think we are going to have to address that, now, on a bipartisan basis.”

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Democrats rode a wave of health care concerns to win back control of the House Tuesday night while Republicans tightened their grip on the Senate, a recipe for legislative gridlock unless lawmakers from both parties find a way to work together.

During a lengthy press conference in which he discussed the election results, President Donald Trump listed lowering drug prices as among the areas on which he believes he can work with Democrats next year.

“Lowering the cost of prescription drugs, these are some of the things that the Democrats do want to work on,” Trump said. “I really do believe we’re going to be able to do that.”

House Democratic Leader Nancy Pelosi, the presumptive next speaker, told reporters Wednesday that passing drug cost legislation is a “caffeinating issue” for her caucus and that she will push for a bill enabling direct government negotiations over drug prices.

“We believe we have a responsibility to seek common ground,” she said. “But where we cannot, we must stand our ground.”

The courts could scramble the health care agenda even before the new Congress is sworn in if a federal judge in Texas sides with Republican attorneys general and the Trump administration in a case challenging the constitutionality of Obamacare. Such a move threatens the law’s patient protections as well as the Medicaid expansion that covers tens of millions of people.

House and Senate Republicans who previously voted to roll back protections for Americans with pre-existing conditions rushed to introduce legislation before the election supporting the safeguards. But the House measures were non-binding resolutions, while the Senate bill was crafted in a way that would have allowed insurers to refuse to cover the costs of treating some conditions. Any court decision to gut those protections could prompt efforts to reinstate some safeguards.

After a decade’s worth of bruising health care battles, newly ascendant House Democrats are skeptical bipartisanship is possible on this issue. They anticipate Republicans still in control of the Senate would demand a host of unacceptable conservative policy concessions in exchange for their votes to restore patient protections.

“So far during the Trump administration, there’s been a predictable pattern: Democrats have been willing to work together across party lines to make health care markets work better, while Republicans have been, at most, interested in using health care as a hostage in negotiations,” said a senior Democratic aide. “It would be great to see that dynamic change in the next Congress, but I’m not holding my breath.”

Democrats say they plan an aggressive double-edged strategy in the House — investigating Trump administration actions that chipped away at the Affordable Care Act and pushing legislation to strengthen health insurance markets, rein in drug prices and address the opioid epidemic.

“The Energy and Commerce Committee will follow through on Democrats’ commitment to lower health care and prescription drug costs for consumers,” said Rep. Frank Pallone (D-N.J.), who’s in line to take the chairmanship of the influential House panel.

Democrats are expected to hit the Trump administration with a barrage of investigations, many focused on health care. That would put high-ranking officials in the position of defending unpopular policies aimed at weakening the health law, while likely chilling more administrative efforts to do the same.

Health care will be a big part of the investigative agenda, House Oversight Chairman Elijah Cummings (D-Md.) told POLITICO. “We’re going to be looking at these efforts to dismantle the Affordable Care Act, looking at the effort to take away the pre-existing condition protections.”

The letters Democratic committee heads have sent to the administration over the past two years provide a road map to what they will tackle now that they hold subpoena power, according to aides. They include demands for information on the HHS’ role in detaining migrant children separated from their parents, on the Trump administration’s decision to back red states’ anti-ACA lawsuit and on efforts to roll back Obamacare’s contraception mandate.

Steny Hoyer of Maryland, the No. 2 House Democrat, said the new majority plans to call top administration health officials to testify.

“They’re going after pre-existing conditions in the courts,” he said. “They’ve authorized [short-term] junk plans, which are a pretense of health care security, and are allowing those policies to be extended from 90 days to 364. The [cost-sharing reductions] they’ve undermined, the family planning programs they’ve clearly gone after, the shortened open enrollment period, where they’ve eliminated the budget for informing the American people about what their options are. We need to have hearings about all of that.”

Outside liberal groups that work with Democrats on health policy say the oversight blitz will serve multiple functions.

“There’s a serious, real need for this but, also, it is a kind of classic way to gum up the works in the administration,” said Shawn Gremminger, senior director of federal relations at the liberal health advocacy group Families USA. “If you keep them busy enough, it keeps them from necessarily rolling out a lot more.”

Gremminger also anticipates the planned investigations will trigger turnover at HHS and other federal agencies.

“It would not be at all surprising if a lot of senior administration people working in our space say, ‘All right, I’m done,’” he said. “The prospect of spending most of your days going between subcommittee hearings to testify — I think most people just aren’t interested in doing that.”

Lawmakers on both sides of the aisle also say they want to do more on drug pricing and take further steps to address the opioid epidemic. They may also revisit some version of the legislation that failed last year that would have shored up Obamacare individual markets and lowered consumer premiums.

Incremental changes, like increasing transparency around drugmakers’ relationships with pharmacy benefit managers to avoid collusion to keep prices high, could get bipartisan support. The expansive Medicare Part B drug payment pilot that the administration rolled out also is likely to get more support from congressional Democrats than Republicans.

However, Democrats are not likely to find any support across the aisle for government negotiation of drug prices, but they will continue to hammer this popular liberal demand ahead of the 2020 election. The parties may be able to work together, however, on bills to shine a light on drug companies’ relationships with pharmacy benefit managers and crack down on any collusion that keeps prices high.

Adam Cancryn and Sarah Karlin-Smith contributed to this report.