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Is It Time to Find a Bipartisan Solution to Health Care?

First Read is your briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter.
Image: Exterior of US Capitol
(FILES) The US Capitol is shown on April 28, 2017 in Washington. (File) US congressional leaders on May 1, 2017 unveiled a bipartisan deal funding government through September, with a compromise that includes President Donald Trump's call for increased military spending but ignores his demand to fund a border wall.The agreement was struck late Sunday after weeks of tense negotiations that saw the threat of a government shutdown emerge just as Trump was to mark his 100th day in office.Saul Loeb / AFP - Getty Images

First Read is your briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter.

Is it time to find a bipartisan solution to health care?

With Senate Republicans headed back to the drawing board on health care — after not having enough votes to pass their reform this week — here’s a radical idea: Why not try to find a bipartisan solution? After all, it’s not too hard to imagine that there would be a filibuster-proof 60 votes to 1) keep Obamacare in place, 2) shore up the markets in places where the law is struggling, and 3) add conservative reforms to it, including medical malpractice reform.

“This is not for Republicans to fix or Democrats to fix — this is for us as Americans to fix,” Sen. Lisa Murkowski, R-Alaska, said, per NBC’s Benjy Sarlin. “Democrats and Republicans need to work together,” Sen. Ben Cardin, D-Md., said on “MTP Daily” yesterday. But instead, Senate Republicans have pursued a partisan approach via a reconciliation process that requires just 50 votes — but that also likely excludes other reforms because of budget rules.

GOP strategist Michael Steel told one of us yesterday that Republicans owe it to their voters to find a way to repeal and replace Obamacare. And that’s probably the best argument for Republicans to continue to find a partisan solution. But here’s the counter-argument: If the Senate GOP bill already preserves much of Obamacare’s architecture — the individual market, subsidies to help poorer Americans pay for it — then why not try a bipartisan solution? Many American voters, after all, might reward the Republicans, Democrats, and president who finally ended the Health Care Wars.

Of course, we understand why Senate leaders, both Republican and Democrats, want to pursue partisan strategies, because it helps their politics. But remember, a one-party solution isn’t going to stick; if Republicans ultimately pass their repeal-and-replace, Democrats will pass their own the next time they’re back in power. By the way, today is the FIFTH anniversary of the 5-4 Supreme Court decision upholding the Affordable Care Act’s individual mandate.

Contrary to claims, Obamacare isn’t collapsing, per CBO

Relatedly, it’s important to point out that, contrary to GOP claims, the individual insurance markets under Obamacare are LARGELY stable. Here’s the Congressional Budget Office: “Although premiums have been rising under current law, most subsidized enrollees purchasing health insurance coverage in the nongroup market are largely insulated from increases in premiums because their out-of-pocket payments for premiums are based on a percentage of their income; the government pays the difference between that percentage and the premiums for a reference plan… Nevertheless, a small number of people live in areas of the country that have limited participation by insurers in the nongroup market under current law.”

Additionally, the CBO says the Senate bill has its own problems when it comes to the individual market. “[U]nder this legislation, nongroup insurance markets would continue to be stable in most parts of the country... In the agencies’ assessment, a small fraction of the population resides in areas in which — because of this legislation, at least for some of the years after 2019 — no insurers would participate in the nongroup market or insurance would be offered only with very high premiums.”

The GOP’s health-care effort isn’t dead — yet

Under any other Senate GOP leader, we’d say that the Republican health care effort is dead. But Mitch McConnell isn’t any other GOP leader, and if someone can find a way to bridge the Rand Pauls/Mike Lees/Ted Cruzes with the Susan Collinses/Dean Hellers/Lisa Murkowskis, it’s McConnell. All of that said, time isn’t on McConnell’s side. As a Senate Republican crafting the legislation told us, more time doesn’t make passage easier. That’s why McConnell tried to ram through the legislation this week.

How Trump has been largely sidelined in this Senate debate

“If Republicans do manage to broker a deal … it is not likely to be because of Mr. Trump’s involvement,” The New York Times writes. “Until Tuesday afternoon, the president was largely on the sidelines as the fate of one of his most important campaign pledges played out.” More: “A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan — and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.”

Ouch. This morning, Trump took to Twitter to blast The Times. “Some of the Fake News Media likes to say that I am not totally engaged in healthcare. Wrong, I know the subject well & want victory for U.S.,” he tweeted. Our follow-up: Then why hasn’t he held a town hall on the subject? Or given a major speech outlining why this GOP plan is the right policy?

NBC’s Whip Count: Nine Republicans oppose the current Senate bill

Per NBC’s Capitol Hill team, nine Republicans have stated their opposition to the current Senate health-care bill.

  1. Sen. Rand Paul, R-Ky.
  2. Sen. Ted Cruz, R-Texas
  3. Sen. Mike Lee, R-Utah
  4. Sen. Ron Johnson, R-Wis.
  5. Sen. Dean Heller, R-Nev.
  6. Sen. Susan Collins, R-Maine
  7. Sen. Rob Portman, R-Ohio
  8. Sen. Shelley Moore Capito, R-W.Va.
  9. Sen. Jerry Moran, R-Kan.

About that Time magazine cover of Trump in his golf clubs? It’s fake

The Washington Post: “The framed copy of Time magazine was hung up in at least five of President Trump’s clubs, from South Florida to Scotland. Filling the entire cover was a photo of Donald Trump. ‘Donald Trump: The “Apprentice” is a television smash!’ the big headline said. Above the Time nameplate, there was another headline in all caps: ‘TRUMP IS HITTING ON ALL FRONTS . . . EVEN TV!’ This cover — dated March 1, 2009 — looks like an impressive memento from Trump’s pre-presidential career. To club members eating lunch, or golfers waiting for a pro-shop purchase, it seemed to be a signal that Trump had always been a man who mattered. Even when he was just a reality TV star, Trump was the kind of star who got a cover story in Time. But that wasn’t true. The Time cover is a fake. There was no March 1, 2009, issue of Time magazine. And there was no issue at all in 2009 that had Trump on the cover.”

About that $15 minimum wage in Seattle? It doesn’t seem to be working that well

“Since the law raised the wage in stages, they studied it in stages. The results of the first jump, from $9.47 to $11 an hour, were released last year, and seemed to show that the effects on earnings were pretty small — an increase of about $72 every three months — and that low-wage employment declined slightly," Bloomberg View's Megan McArdle writes. “The University of Washington released its second study, this one covering the increase from $11 an hour to $13. And this study found huge effects: For every 1 percent increase in their hourly wage, low-wage workers saw a 3 percent reduction in the number of hours worked. As a result, they lost about $125 in earnings a month, clawing back the entire gain from the earlier hike and more.”