Senate Democrats hold a lot of cards right now as Republicans are scrambling to clean up the mess popular vote loser Donald Trump has dumped on them with just about every action he's taken, but particularly with regards to the Affordable Care Act. His sabotage efforts have been both broad and deep but the latest, most extreme action of cutting off cost-sharing reduction payments to health insurers who are legally obligated to subsidize some lower-income customers’ costs has Republicans panicking. That leaves Democrats in a position to hold firm on protecting the law.
Sens. Lamar Alexander of Tennessee and Patty Murray of Washington have been working in the Senate Finance Committee on legislation to make it abundantly clear to Trump that he has to pay the CSRs, clearing up any legislative language to the contrary. But Republicans being Republicans, they want to do what they can to undermine the law while they're doing that.
That means giving states more "flexibility," and when they say "flexibility" they mean making it easier for insurance companies to only cover healthy people, or as The Hill, a right-leaning D.C. paper puts it, "to expand a program that allows states to waive Affordable Care Act regulations." Democrats, however, are coming around to to the idea that they don't have to play any part in that
“Republicans in the House and Senate now own the health-care system in this country from top to bottom, and their destructive actions, and the actions of the president, are going to fall on their backs,” Senate Minority Leader Charles Schumer (D-N.Y.) said on Friday.
Or as one senior Democratic aide says, "[Trump] is taking hostages you can't shoot. […] Add his personal unpopularity and I promise you no Democrat is feeling the heat […] to cave to what the president wants because he is asking for unpopular things and threatening things [that] are popular."
Health insurance that you can afford and that you can't lose because you get sick is one of those popular things, the thing that got so many people outraged that it meant the Senate couldn't pass Trumpcare to take it away. There's no reason on earth for Democrats to negotiate on that, not as we're inching closer and closer to an election year. Republicans, for the first time, are negotiating to make Obamacare better—that's how scared they are by this. Democrats really seem to get that, and really seem to have internalized the idea that they don't have to make concessions that will hurt people.