What Does Trump Really Think About the Alexander-Murray Bailout?

The truth about what President Trump really wants on the cost-sharing reimbursements of Obamacare remains, well, confusing. It’s been a back-and-forth from the president since it was first learned this week that Lamar Alexander, a Republican, and Patty Murray, a Democrat, were working on a deal for a temporary appropriation of money to reimburse health insurers who were offering affordable plans to low-income customers.

The Trump administration had announced last week that it was ending the CSR payments, which conservatives have considered illegal, since Congress did not appropriate the funds for that purpose. Trump called the payments a “gravy train” for insurers. There is concern among many health-care experts that without the payments or some other reforms, the withdrawal of insurers from the low-income, high-risk market will accelerate and could destabilize an already precarious situation. The Alexander-Murray solution would extend the payments for a short time—but for those opposed to Obamacare, the deal would essentially codify one of the government interventions conservatives argue distorts the market.

The scenario encapsulates the difficulties of health-care politics, and it’s not clear the president is sure where to go. Let’s examine where he’s been over the past three days.

On Tuesday, when asked about the Alexander-Murray deal, Trump revealed his administration had been “involved” in the discussions. Alexander later said he had spoken on the phone with Trump the previous week and had been encouraged to find a legislative solution to the CSR issue. But later that evening, Trump seemed to back away from any possibility he was supportive of their mission. “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,” he said in a speech to the Heritage Foundation.

Trump then seemed to make his opposition to reinstating the CSR payments clear in a Wednesday morning tweet. “I can never support bailing out ins co's who have made a fortune w/ O'Care,” he wrote. White House press secretary Sarah Huckabee Sanders suggested in her briefing later on Wednesday that the Alexander-Murray deal didn’t have enough reforms to have the president’s support. “This president certainly supports Republicans and Democrats coming to work together,” Sanders said. “But it's not a full approach, and we need something to go a little bit further to get onboard.”