We're going down to the wire again in the Senate on healthcare reform. The American Health Care Act finally passed the House, but CBO hasn't scored the latest version. If the loss in coverage is still as large as the last version — up to 24 million by 2026 — it will only reinforce the Senate's determination to make significant changes to get better coverage numbers.
And they'll have to do that while threading the needle between conservatives like Sens. Ted Cruz and Rand Paul, and moderates like Sens. Bill Cassidy and Susan Collins. Ideally, Republicans would also make an effort to court moderate Senate Democrats, who are going to be under enormous pressure to "just say no" to anything Republicans propose. Bipartisan support can help make any reforms more stable in the long run — something insurers, providers, and the millions of Americans relying on individual coverage want.
Mission impossible? Maybe not.
There's a big, basic trade-off that might work: Republicans would agree to stabilize the individual insurance market, and even consider targeted coverage expansions, in return for Democrats compromising on Medicaid reforms and embracing much greater state-based flexibility that could enhance competition among insurers, doctors, and hospitals, and slow entitlement spending.
This compromise would reflect a growing consensus....