OPINION: Calling all grown-ups! Bi-partisan group seeks to get health care unstuck

Aug. 03--Finally, some good news: It appears there are at least 40 grown-ups in the U.S. House of Representatives.

And they're looking for colleagues in both parties who want to be grown-ups, too.

After years of impotent congressional dithering, 43 House lawmakers -- 21 Republicans and 22 Democrats -- have coalesced around a plan to stabilize state health insurance exchanges roiled by uncertainty and advance some modest Obamacare reforms that have attracted support from both parties.

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The group, led by Republican Rep. Tom Reed of New York and Democratic Rep. Josh Gottheimer of New Jersey, calls itself the Problem Solvers caucus. But let's just call them the grown-ups.

Their prescription for what ails Obamacare is unapologetically pragmatic:

* Fund the cost-sharing subsidies that insurance companies participating in the state insurance exchanges established under Obamacare say are critical to keeping coverage affordable for individual policy holders.

* Amend the Obamacare mandate that requires companies with more than 50 employees to provide coverage for their workers so that only companies with more than 500 workers are affected.

* Make it easier for states who think they've found better ways to honor the spirit of the Affordable Care Act to get waivers from coverage rules that limit their flexibility.

* Scrap a 2.3% tax on devices that manufacturers sell directly to hospitals and other health care providers.

The caucus is a group of centrists that emerged and has been exploring the parties' intersecting health care interests informally for several months. Their discussions intensified late last week after the Republicans' so-called skinny repeal of Obamacare collapsed in the Senate, and Monday the caucus issued a news release detailing the agreement they hope to translate into legislative language when members of the House and Senate return to Washington after Labor Day.

The Problem Solvers' prescription is founded on the assumption, widely shared in both parties, that the market for the individual insurance policies will soon collapse without congressional action to guarantee cost-sharing subsidies. The Affordable Care Act is predicated on the payment of those subsidies, but lawmakers have refused to fund them since 2010, when Republicans won control of the House.

President Donald Trump seems to be anticipating that implosion almost gleefully, and he has even threatened to accelerate it by suspending the subsidy payments unilaterally in the belief that Democrats will bear the lion's share of the electorate's anger for whatever chaos ensues.

But more practical Republicans, including House Ways and Means Committee chair Kevin Brady, think sabotaging the current law in the absence of a viable replacement is neither politically nor morally tenable.

Rep. Fred Upton, R-St. Joseph, the only Michigan lawmaker among the caucus' charter members, agrees.

"The path forward to fixing the health care mess is seeking bipartisan, commonsense

common ground," he said in a news release issued jointly by Reed and Gottheimer. "At the top of our list is stabilizing insurance markets and ensuring lower premiums for patients."

In a quick poll I conducted Monday by telephone and e-mail, only one of the nine lawmakers who represent the Detroit region in the U.S. House -- Dearborn Democrat Debbie Dingell -- said he or she was ready to enlist in the Problem Solvers Caucus.

Spokespeople for Rep. Mike Bishop, R-Rochester; Rep. David Trott, R-Birmingham; and Rep. Paul Mitchell, R-Dryden; said they're deferring any commitment to the group for now. Rep. Sander Levin, R-Royal Oak; the ranking Democrat on the House Ways and Means Committee, said he hasn't joined the caucus but views its participation as a constructive step in the health care debate.

Three others -- Tipton Republican Tim Walberg, and Democrats Brenda Lawrence (Southfield) and John Conyers (Detroit) -- didn't respond to my request.

Dingell says she's told colleague Upton and caucus chairs Reed and Gottheimer she's ready to sign on to their effort, but has been told she won't be admitted until another Republican signs up under a "Noah's Ark rule" that permits lawmakers to join only in bi-partisan pairs.

Gottheimer's spokesperson Melissa Miller says the caucus was split evenly between the two parties until one Republican member she wouldn't identify got cold feet. So Dingell will have to wait for at least two of her Republican colleagues to take the plunge before she's recognized as another vote for bipartisan sanity.

How about it, Rep. Trott? Rep. Bishop? Rep. Walberg? Rep. Mitchell?

Is there another grown-up in the House?

Contact Brian Dickerson: [email protected]

CORRECTION: A previous version of this post incorrectly stated that Rep. Paul Mitchell and Rep. Sander Levin did not respond to my request for comment about the Problem Solvers Caucus. Their responses are summarized above.

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