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Governors from both political parties told Congress on Thursday that they supported immediate action on modest, bipartisan steps to repair the Affordable Care Act without repealing it, even as the Trump administration continued to encourage efforts to dismantle the law. Testifying at a hearing of the Senate health committee, governors from Colorado, Massachusetts, Montana, Tennessee and Utah endorsed proposals to stabilize health insurance markets by providing federal money for continued payment of subsidies to insurance companies to offset the cost of discounts provided to low-income people. (Pear, 9/7)

From Massachusetts to Utah, the governors agreed that guaranteeing payments to ACA insurers to help defray certain coverage expenses for consumers ranks as the most urgent step Congress should take. The cost-sharing-reduction subsidies, which reimburse insurers for discounts they must give roughly 7 million lower-income customers for health plans’ out-of-pocket costs, will total as much as $10 billion next year. (Eilperin and Goldstein, 9/7)

The support from the governors seemed to further isolate Trump on the issue. But with partisan feelings heightened by the failed Republican effort to dismantle former President Barack Obama's health law, the prospects for even a modest effort to shore up the Affordable Care Act are uncertain. Health panel chairman Lamar Alexander, R-Tenn., said in a brief interview it was "a good bet" the narrow measure would be limited to extending the payments to insurers and making it easier for states to get exemptions to some of the statute's requirements. (Fram, 9/7)

Senate Health Committee Chairman Lamar Alexander (R., Tenn.) said he hoped to reach an agreement with Democrats by the end of next week on the insurer payments, which offset subsidies they provide low-income consumers. At a hearing Thursday, Mr. Alexander suggested he would be willing to authorize the subsidy payments for multiple years, as Democrats are demanding, in exchange for “structural changes” to the ACA, also called Obamacare. (Hackman, 9/7)

Funding CSR's is the easy part, Alexander said. He was looking for tweaks that will appease conservative Republicans who for years have told their constituents that Obamacare is a failure. They would be hard-pressed to appropriate money to fund it without some substantive changes. Alexander presented the dilemma to the governors as an opportunity to ask for specific changes they'd like to see happen fast. "This train may move through the station, and this is the chance to change those things," he said near the end of the hearing. "And so if you want to tell us exactly what those are, and we got it by the middle of next week, we could use it and it would help us get a result." (Kodjak, 9/7)

The governors' requests for renewed federal reinsurance funding drew less support. Although the governors said their states cannot raise money quickly enough to provide reinsurance to offset high-cost patients' care, Alexander said that would have to wait for a longer-term solution. "Creating a brand new reinsurance pool in the next 10 days is just not going to happen," he said. "There isn't any way to do that." (Lee, 9/7)

But a clearly frustrated Alexander said at the end of Thursday’s hearing that he couldn’t pass that kind of bill. “To get a Republican president, House and Senate to vote for just more money isn’t going to happen in the next two or three weeks,” he said. That, however, did not convince the governors, who said this money was essential in stabilizing the markets. “One of our great challenges is to get more people participating in the system; a reinsurance pool is one of the best ways to do that,” said Gov. John Hickenlooper, a Democrat from Colorado. (Rovner and Bluth, 9/7)

Democrats are pushing for it, but Alexander has warned that it costs too much money and instead states could enact the program on their own. (Sullivan, 9/7)

Governor Charlie Baker, appearing before US senators Thursday, said his administration is working to establish a fund to help stabilize Massachusetts health insurance rates in case President Trump ends the federal subsidies that many insurers and consumers rely on. The Baker administration’s plan to create the fund needs approval from federal officials. (McCluskey, 9/7)

Democratic U.S. Sen. Elizabeth Warren does not agree with President Donald Trump on much, if anything. Republican Gov. Charlie Baker is no fan of the president's either. So there they were Thursday, an unlikely duo, joining forces during a Senate hearing on Capitol Hill to tag team the White House in an effort to undermine Trump's threats to sabotage Obamacare. (Murphy, 9/7)

Gov. Bill Haslam called on Congress on Thursday to move quickly to stabilize the individual health insurance market and then embark on “a serious effort” to deal with skyrocketing health care costs. “All of us – Republicans, Democrats and independents – should agree that our current path is not a sustainable one,” Haslam told a Senate panel. (Collins, 9/7)

One of the few things that Republicans and Democrats broadly agree on is that states should have some flexibility to experiment with different ways to pay for and deliver health care. But they disagree — strongly — on how much. In fact, Republicans don’t agree with one another on this, and that dissent helped sink efforts this summer to “repeal and replace” the Affordable Care Act. Bridging these divides will help determine the success of a bipartisan effort in the Senate this month to help shore up the individual health insurance market. (Rovner, 9/7)

Ron Wyden, a key Democratic senator on health-care matters, said he’s on board with giving states more flexibility in how they run Obamacare -- so long as they don’t use the new freedom to weaken the health law’s protections. Republicans are proposing more flexibility in the use of so-called 1332 waivers that would give states more say in how the program is run, as part of potential compromise legislation to stabilize the law’s markets. Governors have also asked for more flexibility. (Tracer and Edney, 9/7)