WASHINGTON — In a meeting with Republican senators Tuesday to discuss health care reform, President Donald Trump gave them support to move in a different direction from the House-passed version of the legislation which he described as "mean," according to two Senate aides whose bosses attended the lunch.
“He talked about making sure we have a bill that protects people with pre-existing conditions and helps people. We talked a little bit about the tax credit to make that work for low income elderly people," Sen. John Thune, R-S.D., who attended the meeting, said. "And he certainly is fine with us taking a different direction with what the house did."
After the House passed its bill last month, Trump took a victory lap, holding a news conference in the Rose Garden flanked by members of Congress whom he praised for passing a "great plan."
Tuesday's lunch meeting resulted in little tangible progress on how to gain the support of nearly all Republican senators needed for it to pass the Senate.
Fifteen senators traveled down Pennsylvania Avenue to the White House to talk about the issue at a critical time in the crafting of legislation that would roll back aspects of the Affordable Care Act, or Obamacare, and replace it with Republican ideas.
Republican senators still disagree on major components of potential legislation, and the meeting with Trump did little to change their minds. Instead they expressed their concerns to a president who encouraged them to work out their differences, multiple senators who attended the meetings said.
“I think we have the same dynamic in the caucus that we’ve had for a long time — people who are in different places on how we fix Medicaid and other issues,” Thune told reporters after returning to the Capitol from the White House.
Sen. Rob Portman, R-Ohio, who is protective of the Medicaid program that expanded under Obamacare in Ohio, said that the meeting did not bring senators closer to an agreement on a final bill.
“No that wasn’t the purpose of it,” Portman said.
At the beginning of the lunch, which was open to the press for a few minutes, Trump said that the Senate is coming up with “a phenomenal” bill.
But the definition of phenomenal hasn’t been agreed upon between senators. Differences still exist over how to deal with Medicaid and the expansion of the program authorized under Obamacare.
There seems to be agreement, however on protecting people with pre-existing conditions. Thune said Trump said senators have to “make sure” to protect them.
But ensuring people with pre-existing conditions have coverage and protecting people with Medicaid are expensive, leading to another major issue of contention — which Obamacare taxes to keep in place. The House bill repealed $1 trillion worth of Obamacare taxes while the Senate bill is likely to be more generous, costing more money.
Senator David Perdue, R-Georgia, said the disagreement on which taxes to keep is a dividing the conference. The major taxes include a tax on insurance companies, a medical device tax, a tax on investment income and an income tax on couples making more than $250,000 per year.
“That’s the part that’s moving around on us,” he said.
One division between Congress and Trump is the issue of cost-sharing reduction payments, which are subsidies that help low-income customers with insurance pay for out-of-pocket costs. Trump has threatened to halt the payments, a move that would cause insurance companies to exit the individual insurance market, leaving people without access to health insurance or fewer options.
When Sen. Joni Ernst, R-Iowa, was asked if Trump committee to continuing CSR payments, she said, “It was just a good discussion.”
Republican leaders are working to flesh out differences between senators on the content of a bill. They can agree that time is running out while insisting to reporters that no one is placing an “arbitrary deadline” on the process.
Some Republicans had hoped to vote on a bill before July, but time is running out. The Senate is mandated to have a cost estimate from the Congressional Budget Office before they vote. A CBO analysis of the bill will take ten to 14 days, meaning text of legislation would have to be sent to the CBO by the end of the week.
Sen. Orrin Hatch, R-Utah, was skeptical that a bill could be written in the next three days. “By the end of this week? I don’t think so,” Hatch told reporters.