Pass Healthcare Bill Now or Else: White House to Senate

Washington: The White House has stepped up demands for revived congressional efforts on health care and suggested senators cancel their entire summer break, if needed, to pass legislation after failed votes last week.

Aides on Sunday said President Donald Trump is prepared in the coming days to end required payments to insurers under the Affordable Care Act as part of a bid to let "Obamacare implode" and force the Senate to act.

It was all part of a weekend flurry of Trump tweets and other statements insisting the seven-year GOP quest to repeal former President Barack Obama's signature legislative achievement was not over.

"The president will not accept those who said it is, quote - Time to move on," White House adviser Kellyanne Conway said. Those were the words used by Senate Majority Leader Mitch McConnell, R-Ky, after the early Friday morning defeat of the GOP proposal.

Conway said Trump was deciding whether to act on his threat to end cost-sharing reduction payments, which are aimed at trimming out-of-pocket costs for lower-income people. "He's going to make that decision this week, and that's a decision that only he can make," Conway said.

For seven years, Republicans have promised that once they took power, they would scrap Obama's overhaul and pass a replacement. But that effort crashed most recently in the Senate Friday, and that's when McConnell said it was time to focus on other policy matters.

Republicans hold a 52-48 majority in the Senate, where no Democrats voted for the GOP bill and three Republicans defected in the final vote Friday. One of the GOP defectors, Sen John McCain, has since returned to Arizona for treatment for brain cancer, "Don't give up Republican senators, the World is watching: Repeal & Replace," Trump said in a tweet.

White House budget director Mick Mulvaney, when asked on Sunday if no other legislative business should be taken up until the Senate acts again on health care, responded "yes."

While the House has begun a five-week recess, the Senate is scheduled to work two more weeks before a summer break.

McConnell has said the unfinished business includes addressing a backlog of executive and judicial nominations, coming ahead of a busy agenda in September that involves passing a defense spending bill and raising the government's borrowing limit.

"In the White House's view, they can't move on in the Senate," Mulvaney said, referring to health legislation. "They need to stay, they need to work, and they need to pass something."

Trump warned over the weekend that he would end federal subsidies for health care insurance for Congress and the rest of the country if the Senate didn't act soon. He was referring in part to a federal contribution for lawmakers and their staffs, who were moved onto Obamacare insurance exchanges as part of the 2010 law.

"If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!" Trump tweeted.

The subsidies, totalling about USD 7 billion a year, help reduce deductibles and co-payments for consumers with modest incomes. The Obama administration used its rule-making authority to set direct payments to insurers to help offset these costs. Trump inherited the payment structure, but he also has the power to end them.

The payments are the subject of a lawsuit brought by House Republicans over whether the health law specifically included a congressional appropriation for the money, as required under the Constitution. Trump has only guaranteed the payments through July, which ends on Monday.

Sen Susan Collins of Maine, one of the three Republican senators who voted against the GOP health bill on Friday, said she's troubled by Trump's claims that the insurance payments are a "bailout." She said Trump's threat to cut off payments would not change her opposition to the GOP health bill and stressed the cost-sharing reduction payments were critical to make insurance more affordable for low-income people.

"The uncertainty about whether that subsidy is going to continue from month to month is clearly contributing to the destabilization of the insurance markets, and that's one thing that Congress needs to end," said Collins, who wants lawmakers to appropriate money for the payments.

"I certainly hope the administration does not do anything in the meantime to hasten that collapse," she added.

Trump previously said the law that he and others call "Obamacare" would collapse immediately whenever those payments stop. He has indicated a desire to halt the subsidies but so far has allowed them to continue on a month-to-month basis.