Democratic Sen. Chris Murphy Outlines Potential For Bipartisan Health Care Reform

With the failure of the Graham-Cassidy bill to repeal and replace the Affordable Care Act, NPR's Robert Siegel talks to Sen. Chris Murphy, Democrat of Connecticut and member of the Senate health committee, about whether talks will resume for bipartisan reform efforts.

ROBERT SIEGEL, HOST:

With Republicans abandoning their latest effort to replace the Affordable Care Act, some are reaching out to Democrats. Republican Senator Lamar Alexander of Tennessee says he will revive the bipartisan effort in his committee. He says he'll work with Democrats to try to expand insurance options and lower health care premiums. To learn how Senate Democrats are viewing this opportunity, we spoke with Senator Chris Murphy of Connecticut. He sits on that committee, and he says it made a lot of progress before Republicans came out with their bill.

CHRIS MURPHY: What was so maddening about this push to once again pass a repeal bill with only 50 Republicans is that we were 80 percent of the way there to a bipartisan stabilization package. It wouldn't have fixed all of the long-term problems that remain in the health care system, but it would have, you know, at least shored up these exchanges for the next couple of years, given states a little bit more flexibility to design innovative benefits, which is something Republicans wanted.

And you know, we were at the finish line. Republicans walked away to try to get this done. I think it could just take a few days to get that package done. And maybe we can try to work on that over the course of the rest of the year to provide, you know, a little bit of certainty to these markets.

SIEGEL: You've suggested making Medicare available to everyone in the Obamacare exchanges. That I assume would be a nonstarter at this point in the kind of bipartisan discussion that's been going on in the committee.

MURPHY: That's too big an idea for right now. I'd go further than that. I've actually proposed giving everyone in every business the ability to buy into Medicare. But that's not what's on the table. And you know, my hope is that Democrats and Republicans are willing to bend, that we give them a little bit of what they want, which is more flexibility of how these benefits are designed, and that they give us what we want, which is, you know, taking the keys away to the health care system from President Trump so that he can't sabotage it. And I think that that's a deal that could absolutely get done.

SIEGEL: So just to translate that into real terms, what Democrats want would be a guarantee that these cost-sharing reductions - federal payments to insurance companies so that they can offset the reductions they're offering people on their health insurance, people with lower incomes - those would not just be a guessing game every month to month to see if they'd be paid. And you'd be willing to offer more flexibility to the Republicans on what would be offered. How flexible are you willing to go?

MURPHY: So one of the things Republicans have wanted is an additional plan option on these exchanges, something maybe called a copper plan that would be cheaper but would have a lower benefit level. We've always been nervous as Democrats about watering down the benefit levels, but we know it's something that they want.

So I think it's a really worthwhile conversation to be had to get that certainty that you're talking about in exchange for perhaps a cheaper, more catastrophic-looking-like plan on the exchanges available to a broader number of people. I don't like that personally, but I understand this has got to be a compromise. And that is I think the foundation of a potential compromise.

SIEGEL: So that perhaps the healthy 28-year-old who doesn't have many bad health conditions would be able to buy protection against some catastrophic ailment he might suffer.

MURPHY: And also targeted towards those people that are making just enough money that they don't qualify for the subsidies. Those folks that are making, you know, above 400 percent of the poverty level, you know, probably do need some additional choice, a cheaper choice maybe with a little less insurance. That would allow them to be able to afford it. So it's not an unreasonable request that they're making. Democrats have traditionally blanched at it.

SIEGEL: Yep.

MURPHY: But this would be the moment to give a little.

SIEGEL: Bit thinking in terms of the Senate - I mean the Republicans, it's been shown, have been unable to write a bill that keeps their most conservative and their most moderate members onboard. Do the kind of ideas you've just described seem likely to you to be able to bring, say, 30 Republicans and 30 Democrats together behind a bill?

MURPHY: I do think it's likely, and I think the president is forcing Republicans' hands given that he has been, you know, so open in the steps that he's taken, like removing the money to help market the exchanges, to weaken the health care system. I think Republicans worry that if they don't do something, that from a political standpoint, there's going to be some real heat on them if the exchanges continue to wither. And I do think there are some political reasons why, you know, 20 or 30 Republicans might end up joining us on a package that does involve some real reforms that they want, too.

SIEGEL: Seems to be an interesting moment. This is an issue - health care - which when Obamacare was passed, Joe Biden famously mentioned what a big deal it was, and it was. It was a huge Democratic idea finally enacted. Republicans have been running for 10 years against this. And what you're saying is, don't think so big about it; don't think so long-term about it. We've got an immediate problem; let's deal with it over a couple of years.

MURPHY: You've got to crawl before you can walk. And here's what I think is impossible for a lot of people in Washington to think about. What if health care wasn't perpetually a political football? We bludgeon Republicans with it now. They bludgeoned us with it over the last 10 years. And peace of mind is an illusion to American consumers because they're always worried that the protections that they have now will disappear. So I just think it might be interesting to get a small deal done to hint at the idea that maybe this doesn't have to be a cudgel that one party uses to beat the other party over the head with year after year.

SIEGEL: Well, Senator Chris Murphy, Democrat of Connecticut, thanks for talking with us today.

MURPHY: Thanks a lot.

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