President Trump’s decision late Thursday to cut off crucial health-care subsidies has once again torn open the long-festering debate over the Affordable Care Act, increasing the potential for a government shutdown in December and ensuring that the issue will be central in next year’s midterm elections.
The move to end insurer subsidies for low-income patients could spike premiums by as much as 20 percent for those who purchase insurance on the individual market. While Trump and Republican allies argued that former president Barack Obama’s signature health-care reform law is fundamentally flawed, Democrats called the move an act of sabotage against the ACA and pledged to fight it.
Senate Minority Leader Charles E. Schumer (D-N.Y.) told reporters Friday that any consequences from the decision could not be blamed on Democrats.
“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,” he said. “The American people will know exactly where to place the blame when their premiums shoot up and when millions lose coverage.”
Ahead of a Dec. 8 government funding deadline, Schumer declined to draw a hard line when asked whether Democrats would oppose any spending bill that did not include the cost-sharing payments.
“I think we’re going to have a very good opportunity in the [next spending bill] to get this done in a bipartisan way if we can’t get it done sooner,” he said.
House Minority Leader Nancy Pelosi (D-Calif.), in an interview, made a starker declaration about Trump’s cancellation of the subsidies: “We have to try to put a stop to that immediately, these particular pieces of it, because people will die.”
Democrats can block any spending bill from passage in the Senate, where a 60-vote supermajority is needed to pass most major legislation. In the House, Democrats have frequently provided the majority of the votes for bills keeping the government open — giving them significant leverage should they choose to exert it.
Rep. Joe Crowley (D-N.Y.), chairman of the House Democratic Caucus, said Friday that continuing the health-care payments was already high on the party’s list of demands going into the last spending negotiation last month.
“It was a priority then, it’s a priority now, and it will be a priority in the future as well for us,” he said. “What will help the Affordable Care Act work is stability, and what the president is doing is to purposely destabilize the system. . . . It’s a willful act of sabotage.”
Just hours after Trump’s announcement, Democrats began blasting supporters with emails, asking them to sign petitions — pages that inevitably lead to fundraising portals as well.
“Obamacare literally saves lives — but Donald Trump doesn’t care. He’s willing to let people die if it means he can claim a big political win,” said a message from the Democratic National Committee. “Call it craven, call it heartless and cruel. But don’t let this moment pass you by.”
Key conservatives, meanwhile, warned that any attempt to continue the subsidies, which were expected to total about $7 billion this year, would be met with fierce resistance.
Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, said the only way he and other GOP conservatives could stomach an extension of the subsidies would be as a bridge to a new, more conservative health-care system.
Trump’s move to end the subsidies and make other changes to health insurance markets by executive action, he said, could create new momentum for the type of health-care overhaul that Republicans have thus far failed to move through the Senate.
“This may create enough energy and buzz to say, ‘Okay, we’ve got to get back to the drawing board and do something pretty quick here,’” he said.
Rep. Tom Cole (R-Okla.), who chairs the House Appropriations subcommittee overseeing health care, said in a recent interview that while he personally supports making the subsidy payments, they would be a tough sell to fellow Republicans who have opposed the Affordable Care Act at every turn.
“I think Democrats are naive on this if they think Republicans are all of a sudden going to vote in significant numbers to sustain a system that none of them have voted for,” he said.
Trump’s decision to reopen the health-care debate comes two weeks after a key deadline passed for Republicans, when special Senate budget procedures that would have allowed the GOP to pass a health-care bill with a 50-vote majority expired. Republicans could add similar instructions to their next budget, which is expected to be on the Senate floor next week, but party leaders have thus far kept the framework squarely focused on a major tax overhaul that is at the center of the GOP agenda.
Passing any significant legislation that advances the Republican health-care agenda is likely impossible under normal Senate rules, which would require at least eight Democrats to break ranks if all 52 Republicans agree on a health bill, which has been an impossible task so far under Trump.
Bipartisan health talks are underway in the Senate, led by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), respectively the chairman and ranking Democrat of the Health, Education, Labor and Pensions Committee, that could include a continuation of the subsidy payments. But it is unclear whether Republicans at large would accept any deal the pair might strike — a reality highlighted Friday by remarks that White House budget director Mick Mulvaney made to Politico, indicating that Trump would not support a “clean Murray-Alexander bill.”
“The president has said pretty clearly that he’s willing to talk to just about anybody about repealing and replacing [Obamacare],” Mulvaney told Politico. “But if the straight-up question is: Is the president interested in continuing what he sees as corporate welfare and bailouts for the insurance companies? No.”
A parallel effort is underway among conservatives to forge a bill that might include continuing the subsidy payments, Rep. Mark Meadows (R-N.C.) said in a Friday interview, citing talks with Sen. Ron Johnson (R-Wis.) and other GOP senators. But any deal, he said, would have to include significant changes to expand health insurance options beyond what the ACA currently allows — something Democrats have fiercely opposed.
“We need to fundamentally address some of the other issues that are increasing premiums,” said Meadows, chairman of the hard-right House Freedom Caucus. “Bailing out insurance companies is not a wonderful conservative talking point, and if that’s all it is . . . then it’s not going to be met with great receptivity” among Republicans.
No comments:
Post a Comment