'He keeps zigging and zagging': the perils of doing a healthcare deal with Trump

Chuck Schumer was at the gym when his phone rang, just over a week after the latest version of the Republican effort to repeal the Affordable Care Act foundered. It was Donald Trump calling the most senior Democrat in the Senate with an idea.

“‘Let’s do some bipartisan work on healthcare,’” the president said, according to Schumer’s account to reporters on Wednesday.

First, Schumer said, Trump suggested Democrats work with the White House on a plan to “repeal and replace” the Affordable Care Act (ACA) – though the president insisted Republicans already had the votes to overhaul the healthcare law.

The Democrat reminded the president that his caucus was fiercely opposed to repealing the ACA – a circumstance Trump often laments.

“I said, ‘Mr President, we’re not for repeal and replace. We have fought you on it and we’ll continue you to fight you on it,’” Schumer said.

However, Schumer told him, for the past several weeks Republican senator Lamar Alexander, the chairman of the Senate health, education, labor and pensions committee, and Patty Murray, the committee’s top Democrat, were working on a plan they hoped would stabilize healthcare marketplaces under the Affordable Care Act.

“We talk for a few minutes about it – the subject always changes but I try to bring him back to it,” Schumer said with a smile. “In the end he says, ‘I’ll call Lamar, you call Patty. Let’s encourage them to work.’”

Over the course of the next week and half, Trump called Alexander several times and voiced support. Alexander told reporters these calls were crucial to reaching a deal.

Then last week, in a late-night announcement, the White House said Trump would halt federal payments to insurers. That decision, which Schumer said “came as a surprise to just about all of us”, followed an executive order that would allow, among other changes, the sale of cheaper, less comprehensive insurance policies. The twin blows, which Democrats have called “sabotage”, threatened to unravel the ACA by causing insurance premiums to soar and insurance companies to abandon the marketplaces.

“That actually sped up the negotiations between Lamar and Patty,” Schumer said.

The leading senators worked through the weekend on the proposal, Schumer said. Democrats wanted funding for cost-sharing reductions, payments to insurance companies that help lower the cost of coverage for low-income customers. In exchange, Republicans wanted states to get more flexibility under the law.

They agreed to continue the subsidies for two years while states were granted more leeway under the ACA to let insurance companies skirt certain requirements.

On Tuesday, virtually as the senators announced they had reached an agreement, Trump appeared to bless the proposal, which would fund critical subsidies to insurers that the president himself had abruptly stopped just days earlier.

“It will get us over this intermediate hump,” Trump said during remarks in the Rose Garden. “It is a short-term solution so that we don’t have this very dangerous little period.”

Later that night during a speech to the conservative Heritage Foundation in Washington, Trump took credit for the proposal while signalling a shift in support.

“I’m pleased the Democrats have finally responded to my call for them to take responsibility for their Obamacare disaster and work with Republicans to provide much-needed relief to the American people,” Trump said. “While I commend the bipartisan work done by Senators Alexander and Murray – and I do commend it – I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies.”

The following morning, during a live interview with Axios, Alexander praised Trump’s persistence and involvement.

“Trump completely engineered the plan that we announced yesterday by calling me and asking me to work with Senator Murray to do it,” Alexander said. “I’ve talked with him three times in the last 10 days about it.”

Alexander predicted the plan he crafted would pass “in some form” before the end of the year.

But moments later, Trump returned to Twitter to apparently disavow the plan. “I am supportive of Lamar as a person & also of the process, but I can never support bailing out insurance companies who have made a fortune w/ O’Care.”

Alexander responded to the president’s tweet, saying that he agreed the payments should “benefit consumers and not insurance companies” and said the plan included “strong language to do that”. He offered to work with the White House to reinforce the language.

Amid the confusion over whether the president supports the plan, House speaker Paul Ryan announced his opposition to the plan, echoing concerns raised by some of the most conservative members of his caucus.

By Wednesday afternoon at the White House briefing, spokeswoman Sarah Sanders was asked: “Is it correct, then, to say that President Trump does not support this deal in its current form?”

The White House spokeswoman responded: “Correct. I think he stated that pretty clearly today.”

Washington is visibly struggling to compute. In a floor speech on Wednesday morning, Schumer said the president “keeps zigging and zagging, so it’s impossible to govern”.

Schumer concluded: “Our only hope is maybe tomorrow he’ll be for this again.”