Sen. Lisa Murkowski, R-Alaska, said that limited health insurance options in her state were a primary factor in her decision to vote against a Democratic resolution that would have curtailed cheap short-term health plans promoted by the Trump administration as an alternative to Obamacare plans.
The centrist GOP senator had voted several times against Obamacare repeal last year. However, she voted on Wednesday against the resolution put forward by Sen. Tammy Baldin, D-Wis., that sought to overturn a Trump administration regulation that liberalized short-term insurance plans that do not comply with Obamacare rules.
The resolution failed to advance after the Senate voted 50-50, with Sen. Susan Collins, R-Maine, the only Republican to vote for it. She joined all Democrats to support the resolution, which drew the first official veto threat of President Trump’s presidency.
Murkowski said that the short-term plans offer an affordable option for her state, which struggles to offer enough healthcare services.
She said Alaska has the “highest cost in terms of… care and highest in terms of cost of coverage. Our options are really pretty limited.”
A short-term plan is cheaper than a plan offered on Obamacare’s insurance exchange because it does not have to cover as many benefits nor does it have to guarantee coverage for people with pre-existing conditions or cover essential health benefits.
But Murkowski said that Alaskans need more affordable plan choices. She said that, in 2016, there were 15,000 state residents who paid the individual mandate penalty for not having insurance. The mandate financial penalty will go away in 2019 due to the tax law.
“These short-term plans, while not ideal … is an option for them to consider,” she said of the residents that paid the mandate penalty.
Murkowski did say that states need to do a good job of telling consumers that the plans don't offer as many benefits as a plan sold on Obamacare's insurance exchanges.
She said that the disclosure about the plan's limitations needs to "not just be a tiny boilerplate that nobody can understand."
The administration's short-term rule did include new requirements for disclosures, but experts worry that individuals could still be confused and think the coverage is the same as Obamacare plans.
Democrats hammered Republicans that voted against the resolution, saying that they did not want to help those with pre-existing conditions.
“It’s disappointing that too many Senate Republicans failed to keep their promise to protect people with pre-existing conditions from being denied coverage,” said Baldwin in a statement after the vote.
Democrats were able to force the vote via the Congressional Review Act, which allows Congress to overturn recently implemented regulations, but they had little chance of actually ending the regulation. Trump said that he would veto the resolution and the GOP-controlled House was unlikely to pick it up.
But Democrats looked at the resolution as a way to put Republicans on record on pre-existing condition protections ahead of a contentious November election.
Critics of short-term plans say that the plans will entice younger and healthier people to abandon Obamacare’s insurance exchanges to buy a cheaper plan that offers fewer benefits. This move would cause the exchanges to destabilize because they would not have enough younger and healthier people to offset the claims from sicker people.
Democrats have made healthcare a key focal point of their midterm election strategy, frequently highlighting Republican attempts to repeal Obamacare while on the campaign trail.
Senate Republicans accused Democrats of trying, through the resolution, to eliminate a choice for Americans who can't afford Obamacare.
"With this rule, if you have a pre-existing condition and want to buy Obamacare, you've got it," said Sen. Lamar Alexander, R-Tenn., on the Senate floor Wednesday. "This could not possibly change that because it is a rule, not a law."
Murkowski said that her vote was not meant to roll back pre-existing condition protections.
“Certainly my vote this morning is in no way meant to erode or undermine where I am coming from when it comes to pre-existing conditions,” she said.
Murkowski voted against Obamacare repeal last year, joining Collins, the late Sen. John McCain, R-Ariz., and all of the Senate’s Democrats to defeat a “skinny” repeal bill in July 2017.