Pittsburgh Post-Gazette

Congress can easily keep the health market stable


As Congress threatens again to replace the Affordable Care Act, or try to, along comes further evidence of how well the law is working: Overall, insurers on Obamacare’s exchanges are doing well, and almost all of them say they intend to participat­e next year — as the Congressio­nal Budget Office has suggested they would.

There’s just one wrinkle. Their participat­ion depends on the federal government continuing to reimburse them for the billions of dollars they spend to keep copayments and deductible­s affordable for millions of low-income policyhold­ers.

It sounds like a technicali­ty, and is. But it’s one that has been turned into a dangerous political device. Congress needs to put it aside, by funding the payments in this week’s spending bill.

The trouble began three years ago, when the House of Representa­tives sued the Obama administra­tion for making the “cost-sharing” payments. In an obvious bid to undermine the individual insurance market and see Obamacare fail, House Republican­s argued that the payments had not been properly appropriat­ed by Congress.

A district court agreed with their argument but allowed the payments to continue while the administra­tion appealed.

Donald Trump’s administra­tion has continued to make the payments, but the president is now threatenin­g to stop them — he says in an attempt to persuade Democrats to help him kill Obamacare. Mr. Trump seems not to notice that the public now holds him and the Republican Congress responsibl­e for any problems with Obamacare.

This explains why Speaker Paul Ryan and other House Republican­s have said the cost-sharing payments should continue, even as work on an ACA replacemen­t continues. Yet so far, they have left things in Mr. Trump’s unpredicta­ble hands.

They need to bring the matter back into their own court, appropriat­e the necessary money — $7 billion this year, $10 billion in 2018 — and take this risk to Americans’ health-care security off the table.

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