Murkowski, key Republican vote on health care, says a new Senate bill will be bipartisan and target costs

One of the three Republican senators who cast a deciding vote against repealing "Obamacare" — Alaska's Lisa Murkowski — said Tuesday that she and other lawmakers are discussing plans to create a bipartisan replacement measure that seeks to stabilize the individual insurance market and lower health care costs.

"It can't be just a partisan bill," Murkowski told a luncheon of the Anchorage Downtown Rotary Club on Tuesday. "We went that way with the Affordable Care Act, and as Republicans we fought it for seven years."

An all-Republican version replacing the Affordable Care Act — "Obamacare" — would be worrisome as well, she said.

Murkowski, a member of the Senate's Health, Education, Labor and Pensions Committee, said the committee plans to hold its first hearing on new health care initiatives Sept. 6.

Five state insurance commissioners will be witnesses, including Lori Wing-Heier, director of the Alaska Division of Insurance, Murkowski said.

The 23-member committee will hear from a panel of governors the next day, because they are involved in Medicaid and Medicaid expansion, Murkowski said.

In July, Murkowski joined Susan Collins of Maine and John McCain of Arizona as the only Republicans voting against the so-called "skinny" repeal bill, leading to its failure. Murkowski complained that the measure should have been assembled in an open process rather than in closed-door meetings led by Senate Majority Leader Mitch McConnell.

Murkowski said she and other lawmakers of all political stripes are discussing key measures they want to see in a new repeal effort. The conversations have included House lawmakers, from moderates to members of the very conservative Freedom Caucus, in an effort to find a way forward.

"Why not reduce the cost of health care in the first place, so maybe your insurance costs will be a little more manageable?" Murkowski said to applause.

An initial idea would allow subsidies to be paid to insurers over a one- to two-year period, to give insurers more confidence the support will continue, she said, speaking with reporters.

President Donald Trump has been authorizing the payments to insurers monthly. In July, Trump threatened to end the payments if Congress did not authorize a new health care bill.

After her health care vote, Murkowski was called out in a Trump tweet because, he said, she "let the Republicans, and our country, down yesterday." And despite reports that Interior Secretary Ryan Zinke had called Alaska's senators to threaten retribution in areas of energy and development, Murkowski said she's working cooperatively with Zinke and the administration.

"(Trump) is a man with an agenda who wants to get some things done, and some wins under his belt, so I think he's impatient," she told reporters Tuesday. "But he's the one who said it's complicated, so I keep coming back to, 'Let's not just pass something to pass it, let's pass something we're all going to be proud of, Republicans and Democrats.' "

Providing greater flexibility to states is key, she said. For the 18,000 Alaskans who buy health insurance on the individual market, one possible solution under discussion includes allowing the option of buying into state or federal health care plans, she said.

That idea is to create larger pools of people to spread the risk of a catastrophic medical condition.

"How unattractive are we?" she said. "We are high-risk, we are high-cost. Why does anyone want to say, 'Come on, Alaska, bring all your expensive cases to us?' They don't want us."

Murkowski said she's also teamed up with Sen. Ted Cruz, R-Texas, to discuss bringing more transparency to health care costs, making Republican-favored health savings accounts more useful. The accounts offer tax advantages for health care expenses.

Without knowing the costs of, say, a knee operation, "you are only throwing darts at a dartboard with that money you've saved up," she said.

Cost-saving efforts being considered include finding ways to reduce the price of medicine, a big cost driver, she said.

"You have a renewed sense of 'Let's figure it out,' " she said. "The country is counting on Congress to get their act together."