As Affordable Care Act Repeal Teeters, Prospects for Bipartisanship Build

With his bill to repeal the Affordable Care Act in deep trouble, Mitch McConnell, the Senate majority leader, raised an alternate possibility on Tuesday evening: Either Republicans come together in the days ahead, or he may have to work with Democrats to shore up the deteriorating health law.

That raised a tantalizing prospect: bipartisanship.

The idea is not that far-fetched. For years, Republicans and Democrats have explored avenues for changing or improving President Barack Obama’s health care law, from modest tweaks like raising the size threshold at which businesses must offer their employees health insurance to larger revisions involving how the marketplaces created under the act operate.

Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee, has said he would like to draft legislation geared toward stabilizing the marketplaces and providing a temporary continuation of subsidies paid to insurance companies to offset out-of-pocket medical expenses.

Senator Susan Collins, Republican of Maine, in announcing her opposition to the proposed Republican health care bill, said she wanted to work with members of both parties to “fix the flaws in” the Affordable Care Act.

But any change to the existing law is likely to require Mr. McConnell’s participation — and Speaker Paul D. Ryan’s consent. And before that happens, an all-Republican effort to repeal the health law may have to die a public death.

“At this stage,” said Senator Brian Schatz, Democrat of Hawaii, “there is general agreement among Democrats that it would be premature to meet with Republicans. We have to know that this repeal bill is dead.”

Nearly everyone preaches the virtues of bipartisanship in Congress these days, but on the big issues that define the two parties, few practice it.

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