The Trump administration, thwarted in several attempts to repeal the Affordable Care Act, notably shifted tone Wednesday, opening the door for a bipartisan plan to "fix" the law.
The change came even as a fight escalated between President Trump and Senate Majority Leader Mitch McConnell (R-Ky.) over who is to blame for the Republican Party's failure to repeal Obamacare.
"Both folks in the House and the Senate, on both sides of the aisle frankly, have said that Obamacare doesn't work, and it needs to be either repealed or fixed," Health and Human Services Secretary Tom Price said on the Fox News program “Fox & Friends.” "So the onus is on Congress," he said.
Talk of fixing the law is new for most Republicans. Price and President Trump have long focused only on repealing or replacing it.
The Republican-controlled Congress, despite seven years of campaign promises, has been unable to come up with a repeal plan that can pass both chambers. And Democrats, who see the law as a signature accomplishment for both Obama and their party, have been unwilling to participate in a repeal effort.
Both sides agree that changes are needed to stabilize insurance markets. Large insurers have pulled out of several markets, leaving some consumers with few or no plans from which to choose.
White House Press Secretary Sarah Huckabee Sanders did not back away from Price's wording when asked whether the administration is serious about a plan to fix the law, rather than repeal it.
"We are always looking for best ways to improve and fix the broken Obamacare system," she said in an email.
A spokeswoman for Price, Alleigh Marre, said Price, in his interview, "was characterizing the position of folks in Congress from both sides of the aisle who recognize Obamacare is failing." She did not provide details of which fixes Price would find acceptable.
The shift comes soon after lawmakers intensified their own bipartisan efforts. Last week, Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.), the committee’s senior Democrat, announced plans to begin working on legislation to stabilize the markets.
Industry officials have said a fix could include at least four components:
- Pledging to continue government assistance that the law offers to low- and middle-income consumers to help offset co-payments and deductibles.
- Creating a better reinsurance system to protect insurers from big losses in the event they get an unexpected glut of unhealthy and expensive patients.
- Increasing outreach and marketing to persuade younger and healthier people to buy insurance, thereby balancing out expensive claims from older and less healthy customers.
- Creating new plans or incentives to lure more insurers to sell plans in rural areas.
Even as talk of bipartisanship increases, Republicans remain concerned about political fallout from their core voters, many of whom may be angered by the failure to repeal the existing law.
Tension over that problem prompted the recent infighting between McConnell and the administration.
McConnell told an audience in his home state Monday that Trump had raised expectations unrealistically, in large part because of his inexperience with legislating.
“Our new president has, of course, not been in this line of work before," McConnell said at a Rotary Club in Florence, Ky. "And I think he had excessive expectations about how quickly things happen in the democratic process.”
That elicited a response from Trump, who used his Twitter account during his 17-day stay at his New Jersey golf course to fire back.
"Senator Mitch McConnell said I had 'excessive expectations,' but I don't think so," he wrote. "After 7 years of hearing Repeal & Replace, why not done?"
The public nature of the intra-party fight is unusual. While relations between presidents and congressional leaders from the same party may often be tense, conflicts seldom break out into the open.
But Trump has been increasingly frustrated with what he sees as a lack of support from Republicans in Congress, while lawmakers have grown more concerned that Trump's low standing in the polls and lack of legislative accomplishments could hurt them politically.