Broken health-care pledge tests Collins-McConnell relationship

Sen. Susan Collins (R-Maine) will be a crucial swing vote for Senate Majority Leader Mitch McConnell (R-Ky.) next year, but it may be tougher to strike deals with her after McConnell failed to fulfill a pledge on health care.

The moderate senator told reporters this month that she had an “ironclad” commitment from McConnell and Vice President Pence to pass legislation by the end of the year to stabilize ObamaCare premiums. She wanted that assurance before committing her vote for tax reform. 

But that vote has now been delayed until January due to opposition from House Republicans. 

Collins isn’t accusing McConnell of breaking his pledge, but she is disappointed in the outcome, according to sources familiar with the negotiations on health-care legislation.  

Those sources added that Collins might think twice the next time GOP leaders promise her something. 

{mosads}“She’s disappointed, but she doesn’t see this as a breach of the agreement, she sees it as slipping,” said a Senate GOP aide. “These bills remain very important to her and she’s committed to getting them done.” 

Former Senate Majority Leader Trent Lott (R-Miss.) said McConnell will have to keep a close eye on Collins next year, when the Senate GOP majority will shrink to 51 because of the election of Doug Jones (D) in Alabama this month. 

“I used to have to work on her all the time,” he said. “You don’t wait to talk to Susan until the end, you talk to Susan every day and you have to be sensitive to where her concerns and needs are.”

Collins earlier this month announced that McConnell had promised to pass two bills by year’s end: one authorizing federal subsidies to insurance companies and another funding high-risk pools for older, sicker people.

She said the leader also promised that fellow Republicans would vote to waive an automatic $25 billion cut to Medicare required by “pay as you go” rules. The cut could have been triggered as a result of passing the tax bill with only 51 votes under special budgetary rules.

President Trump is reportedly waiting until Jan. 3 to sign the bill to prevent the Medicare cuts from taking effect, according to Bloomberg.

But the trickier part for Collins was the ObamaCare markets. 

Liberal groups had heaped praise on Collins for helping to thwart the GOP’s ObamaCare repeal legislation over the summer, but those same groups raked her over the coals for backing a tax bill that repeals ObamaCare’s mandate that most individuals have health insurance. Experts and the Congressional Budget Office have warned that ending the mandate could cause coverage losses and premiums hikes. 

Collins countered such criticism by pointing to the assurances she got from McConnell, so liberal critics were quick to pounce once the health-care bills were pushed into January. 

“After casting a vote for health-care repeal in the middle of the night, Susan Collins admitted that she failed to deliver on her promises to Mainers,” said Brad Woodhouse, campaign director of Protect Our Care, an advocacy group allied with the Democrats.

David Leonhardt, a columnist for The New York Times, said that Collins had been duped.

That didn’t sit well with the senator, who vented her frustration this week. 

“I believe that the coverage has been unbelievably sexist,” she fumed on Tuesday.

“They’ve ignored everything that I’ve gotten and written story after story about how I’m duped,” she added, referring to the media.

Even so, Collins isn’t taking out her frustration on McConnell — at least not publicly.

She let him save some face by releasing a statement Wednesday saying she urged the leader to hold off on advancing legislation authorizing federal subsidies to insurance companies and funding high-risk pools for older, sicker people because there likely would not be time to pass it before Christmas.

“It has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs,” she said in a joint statement with Senate Health Committee Chairman Lamar Alexander (R-Tenn.). 

Collins and Alexander said McConnell had also “told us he will uphold his commitment to schedule and support the legislation” to lower insurance premiums.  

Still, Collins had said only a few days ago that that leaders had reaffirmed their commitment to her after she voted to pass the tax bill through the Senate the first time. 

“I feel very confident. I had a very good conversation with the vice president yesterday, and I feel certain that the agreement that I negotiated will be kept this year, by the end of the month,” she told reporters during the Senate-House conference negotiations.   

The plan was to attach the health-care measures to a short-term government funding measure, but it went awry after House Republicans insisted they include anti-abortion language, which Senate Democrats then said they couldn’t accept. 

With time running out before government funding expires on Friday, GOP leaders said the health-care bills would have to wait. 

Senate Republican Whip John Cornyn (Texas) said the Senate leadership did everything it could but fell short due to circumstances outside of its control — namely the internal dynamics of the House.

“I know it was disappointing and I certainly supported her efforts and believe it’s important, but sometimes things around here happen beyond your control,” he said. “I’m optimistic we’ll be able to get it done in January.

One Senate Republican colleague, who requested anonymity, said Collins should have known that Senate leaders couldn’t guarantee that the House was going to accept her deal with McConnell and Pence. 

“I don’t know how the leader can guarantee anything other than a vote on the floor,” said the lawmaker. “Susan’s been here long enough to know that.” 

Instead of taking her leadership to task, Collins is taking an optimistic tone.

She says legislation subsidizing insurance companies for the losses they incur covering sicker populations has a better chance of passing next year anyway. 

A big reason she’s been able to take the setback in stride is because McConnell, Speaker Paul Ryan (R-Wis.) and White House legislative affairs director Marc Short all provided assurances Wednesday that the health-care priories would move early next year, according to a GOP aide. 

“Speaker Paul Ryan called me and said that the House remains committed to passing legislation to provide for high-risk pools and other reinsurance mechanisms similar to the bipartisan legislation I have introduced,” Collins said in her statement. 

Collins revealed that Ryan made the point that by waiting until early next year, Congress will be able to use a new budgetary baseline that will make more funding available for health-care reinsurance programs. 

This report was updated at 8:05 a.m.