Are Republicans going to do a deal on health care?

Republicans are sending mixed signals about extending the Affordable Care Act subsidies due to expire at year’s end. President Donald Trump has suggested both that he would do a deal and that he would “rather not.” At stake is health care for up to 20 million Americans.

Trump said last week he is “open” to extending the subsidies a year to give Congress time to replace Obamacare, said Politico. An extension “may be necessary to get something else done,” Trump said.

But any action will come grudgingly. “I would rather not extend them at all,” he said to reporters. The ambivalence is clear. The White House planned, then canceled, the announcement of a two-year extension of ACA subsidies with “new limitations favored by conservatives,” said Politico.

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Republicans are playing tug-of-war. “Pushback from some Republican lawmakers” stalled the White House announcement, said Scripps News. Obamacare “keeps requiring more and more tax dollars to prop it up,” said Rep. Don Bacon (R-Neb.). But a “small cadre of politically vulnerable Republicans” is pushing for an extension rather than face the wrath of voters who will see their health costs skyrocket, said The New York Times. “We owe it to them to come up with a solution,” said Rep. Jeff Van Drew (R-N.J.).

What did the commentators say?

“Republicans need to get serious about health care,” said the Bloomberg editorial board. Without a subsidy extension, as many as “4 million people will become uninsured,” while others will see their out-of-pocket premiums double. Lawmakers need to work on long-term plans to rein in “America’s soaring health care costs,” but in the short-term they must “soften the shock of lost subsidies.” Bipartisan agreement that “extends and reforms subsidies would be the right thing for taxpayers and enrollees alike.”

Trump is once again discovering that “health care policy is hard,” said Jonathan Cohn at The Bulwark. The “conflicting signals” coming from the White House and its GOP allies should “sound familiar” to anyone who follows health care politics. Republicans have repeatedly promised a “better alternative” to Obamacare. “But their plans almost never materialize,” and the plans that do emerge are “deeply unpopular” because they would leave “many millions of Americans without insurance.” Now that scenario is “playing out yet again.”

The president’s health care plan is a “mirage,” said Ed Kilgore at New York magazine. Perhaps Trump is “going back to the drawing board” after pushback from Republicans who wanted new abortion restrictions as a condition for extending subsidies. But the canceled announcement could also be a “feint” meant to signal action when none will occur. Either way, “health care costs aren’t going away as an issue.”

What next?

The “real moment of truth” for Trump and his party may come when government funding is due to run out in late January, said Axios. It is “not out of the question” that a bipartisan agreement could emerge before the end of December, but a “major push” from Trump would be needed to make that happen. “That seems far off at the moment.”