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Shawn Vestal: Sen. Murray crafts humane, bipartisan fix for Obamacare. As such, it faces an uphill batlle.

Sen. Patty Murray, D-Wash., the ranking member, and Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor, and Pensions Committee, meet before the start of a hearing on Capitol Hill in Washington, Wednesday, Oct. 18, 2017. (J. Scott Applewhite / AP)
Sen. Patty Murray, D-Wash., the ranking member, and Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor, and Pensions Committee, meet before the start of a hearing on Capitol Hill in Washington, Wednesday, Oct. 18, 2017. (J. Scott Applewhite / AP)

When it comes to health care legislation, Patty Murray lives squarely in the congressional minority.

Not the Democrats. The grown-ups.

Earlier this month, she presented a legislative proposal, crafted with fellow Sen. Lamar Alexander of Tennessee, a Republican, to fix some of the immediate problems with Obamacare. Unlike other recent health care legislation, it got a score last week from the Congressional Budget Office – a decent one.

But, because the proposal is practical and humane, it faces a fraught future in Congress and at the White House, where warriors suit up to bury Obamacare, not to fix it.

Murray also recently played a role in obtaining and releasing an internal investigation into one of the key burial strategies: monkey-wrenching efforts to let people know they can sign up for health insurance. (The next open enrollment period starts Wednesday and runs through Dec. 15, by the way.)

Murray requested and then released an inspector general’s report from the Department of Health and Human Services that details how the Trump administration began canceling outreach plans for Obamacare sign-ups immediately upon taking office, wasting more than $1 million and undercutting efforts to bring more people – and particularly more healthy, young people – into the markets.

The report details just one of the ways Obamacare opponents have tried to create a self-fulfilling prophecy: working to make the law fail, while insisting that the law is failing.

Keeping young, healthy people out of the market is a good way of undercutting the risk pool, creating uncertainty among insurers and the insured, and driving up prices. Murray called it an attempt to “sow confusion” about enrollment under Obamacare, which remains the law of the land despite months of Keystone Kops repeal efforts.

“It is appalling that this Administration is so determined to sabotage health care that they were willing to cancel critical enrollment efforts without any consultation or analysis of how patients and families would be impacted as a result,” Murray wrote in a statement.

The report focuses on the cancellation of outreach efforts surrounding an open enrollment period in January. Trump administration officials cut off the efforts on a dime just days after he was inaugurated in January – then backpedaled and reduced the scope of the cuts during a few days of chaos. The back-and-forth wasted $1.1 million in sunk costs, and put an end to more than $5 million in efforts to let people know about the options they have for obtaining health insurance.

Maybe this doesn’t seem like such a surprise – just what’s to be expected from a new administration with new priorities and an unslakeable hatred for the health care law. But the inspector general’s report makes it clear that the decision was carried out rashly and without the mildest inquiry into what the effects would be. And they were warned by HHS officials that the decision “could have potential negative effects on the risk pool for the individual market.”

That means a sicker market. Which means a more expensive market. Which is supposed to be what Obamacare opponents are so very much against.

In theory, I guess. The Trump administration has gone on to cut ACA outreach and consumer assistance efforts further.

Another sorry example of sabotage has been the cancellation of federal “cost-sharing” subsidies that help lower premiums and deductibles. Trump has halted the payments, and they’ve been a target of a lawsuit by House Republicans.

This has resulted in one of the actual, pressing problems facing the ACA: creating uncertainty and instability among insurers, driving them away from the markets. Murray and Alexander, who also teamed up on a bipartisan revamp of the federal education law two years ago, proposed guaranteeing the subsidies for two years as a way of stabilizing markets, among other fixes. A key part of the bill would allow people more freedom to buy catastrophic plans.

By the standards of today’s D.C., it’s been an incredibly sober process, lacking in even a single intemperate tweet or bald-faced lie. It doesn’t seem to even be a part of this Congress – a body that has spent the Trump era repeatedly mounting Rocinante and charging windmills. Trump’s already said he doesn’t like it.

Murray and Alexander detailed their proposal Oct. 18. The CBO scored it Wednesday, saying it would bring down the deficit and stabilize insurance markets, which could reduce premiums, but not have a big effect on the number of insured Americans.

It’s an honest, focused, limited, practical, consumer-oriented attempt to fix a problem.

Let’s hope that doesn’t doom it.


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