White House pushes health plan
But it will take back seat as Congress works to pass spending bill and avoid shutdown.
WASHINGTON – White House officials, desperate to demonstrate progress on President Donald Trump’s promise to repeal the Affordable Care Act, are pushing to resurrect a revamped version of a Republican health care bill before his 100th day in office next week.
Some members of the president’s team have grown consumed by the 100-day mark, worrying that public appraisals at this traditional evaluation period will be brutal and hoping that a last push might bring a measure of salvation.
But at the same moment Trump’s 100-day mark is reached on April 29, there is a far more urgent deadline: Much of the federal government will run out of money. Reaching agreement on a measure to keep the government open past midnight that Friday will be the first priority of Republican leaders when Congress returns Monday from a two-week spring recess.
“I believe that when we first go back, that’s going to be the thing we’ll address immediately and have to get done by Friday,” said Rep. Dan Donovan, R-N.Y.
Republican leaders and the White House have been searching for a health care compromise that could placate enough moderates and hard-line conservatives to win passage in the House.
The latest version of the proposal, published Thursday morning in Politico, would maintain popular benefits in former President Barack Obama’s signature domestic achievement, such as guaranteed coverage for emergency services and maternity care. It would also preserve the health law’s ban on insurers rejecting customers with preexisting medical conditions.
But under the compromise Affordable Care Act replacement, states could seek waivers from many of those mandates if they could demonstrate that premiums would be lowered. States could request an exemption from the existing health law’s “community rating” rule intended to ensure that people with preexisting conditions could not be charged prohibitive premiums — but only if those states establish a high-risk insurance pool where such consumers could purchase governmentsubsidized insurance.
But the complications that remain may be far too difficult to finesse at the same time the House and Senate press to pass a giant spending bill.
Tussles over the spending deadline — including possible debates over top administration priorities such as a border wall and money for immigration enforcement officers — are expected to consume the Capitol. And Democrats will have their own demands, most importantly billions of dollars in subsidies for health insurance companies to lower deductibles and other forms of spending for low-income Americans purchasing health coverage on the Affordable Care Act’s online marketplaces.
Senior Republicans appear unconvinced that a revised health care bill would assure passage in the House. Donovan, an opponent of the original Republican health care bill, said the proposed amendment “really doesn’t address the concerns that I had.”
“We’re in the midst of negotiating sort of finishing touches,” Speaker Paul Ryan, R-Wis., said this week. “It’s difficult to do. We’re very close. It’s basically, make good on the promises that were made.”
In recent weeks, the insurance companies have been strongly urging the Trump administration and Congress to commit to funding costsharing reductions, warning that without the money from the government, the companies will have to sharply raise the prices of their plans offered through the state marketplaces.
The subsidies reduce the amount someone has to pay in deductibles and co-payments when they buy a plan. At stake is roughly $10 billion in payments expected to be made to the insurers this year. Some House Republicans oppose how the Obama administration funded them, and they won a court case potentially blocking the funding that is now on appeal.
Earlier this week, insurance executives met with Medicare officials to plead their case. They left that meeting with Seema Verma, the new Medicare head, with no promises. Trump has publicly toyed with the idea of withholding the subsidies as a way to force Democrats to negotiate over the House proposal, and Verma told the insurers they should look to Congress to appropriate the money.
State insurance regulators weighed in Wednesday, sending a letter to Congress urging it to fund the subsidies for this year and next. “Your action is critical to the viability and stability of the individual health insurance markets in a significant number of states across the country,” officials from the National Association of Insurance Commissioners wrote.