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Trump drops opposition to Obamacare payments

Move removes hurdle in averting federal shutdown

- By Lisa Mascaro and Noam N. Levey lisa.mascaro@latimes.com

WASHINGTON — One potential flashpoint in the negotiatio­ns to prevent a government shutdown was averted Wednesday when the White House announced it would continue — at least for now — to provide crucial funding for the Affordable Care Act.

President Donald Trump had once threatened to withhold money that helps many low-income Americans cover their deductible­s and co-pays, potentiall­y cutting off the so-called cost-sharing reduction payments to insurers for as many as 7 million people who depend on the federal aid.

The funding, totaling about $7 billion this year, soon became a bargaining chip in the current talks over a must-pass spending bill to avert a government shutdown. Democrats seized on Trump’s threat to end the payments as a way to negotiate with Republican­s who wanted extra funding for military programs or the border wall with Mexico.

On Wednesday, House Speaker Paul Ryan, R-Wis., announced the money would not be included in the spending bill. Later the White House signaled it would continue to provide the payments administra­tively rather than through Congress.

It was the second time this week that the administra­tion backed off its demands. Trump also gave up earlier this week on his pursuit of including funding for his promised border wall in the spending bill.

“We’ve now made progress on both of these fronts,” said House Minority Leader Nancy Pelosi, D-Calif.

Though the Affordable Care Act payments have been removed from the debate, several other issues remain, including money to prop up a pension fund for coal miners and abortion restrictio­ns.

Congress will likely need to pass a stopgap measure Friday to fund the government for another week while talks continue.

Obamacare, meanwhile, continues to come under attack by Republican­s seeking to revive their faltering effort to repeal and replace the health care law.

That process gained momentum Wednesday when the conservati­ve House Freedom Caucus, which helped sink the previous GOP plan, threwits backing behind a new amendment designed to win their votes.

The measure would allow states to get rid of some of Obamacare’s most popular mandates, including the ban on higher insurance costs for those with preexistin­g medical conditions.

It could be tacked onto the original bill, the American Health Care Act, which has already been projected to result in 24 million fewer Americans with health coverage over the next decade, according to an independen­t analysis by the Congressio­nal Budget Office.

Under the amendment, states could apply for waivers, for example, to once again allow insurers to charge sick consumers more than healthy ones and could lift requiremen­ts that all health plans cover a basic set of benefits, such as mental health and maternity care.

The proposal was the result of extensive negotiatio­ns between the chairman of the caucus, Rep. Mark Meadows, R-N.C., and a memberof amoderate wing of Republican­s, Rep. Tom MacArthur, R-N.J. Those two factions of the House majority, for different reasons, opposed the GOP’s previous effort to dismantle Obamacare.

“While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health care costs,” the Freedom Caucus members said in a statement.

While supporters say the new approach would lower insurance premiums, it has drawn criticism from many health care and patient advocacy groups, which are concerned that it would eviscerate key protection­s put in place by Obamacare.

Even with the changes, there is still no guarantee the Republican­s will find enough votes to dismantle Obamacare.

Many centrist Republican lawmakers remain concerned that their party’s bill threatens health coverage for millions of vulnerable Americans.

“We have to help those people who were harmed by the Affordable Care Act without harming the people whowere helped by it,” said Rep. Dan Donovan, R-N.Y., who panned the previous effort and said lawmakers still had questions after MacArthur made a presentati­on during a morning meeting of House Republican­s.

“Did everyone get up and cheer? No. Did everyone go, ‘Oh, boo, hiss’? No.”

The spending package would fund government operations through the remainder of the 2017 fiscal year, Sept. 30, and aims to beef up defense spending by about $15 billion.

 ?? EVAN VUCCI/AP ?? House Speaker Paul Ryan, left, and House Majority Whip Steve Scalise arrive for a GOP meetingWed­nesday. Ryan said the $7 billion payment will not be in the spending bill.
EVAN VUCCI/AP House Speaker Paul Ryan, left, and House Majority Whip Steve Scalise arrive for a GOP meetingWed­nesday. Ryan said the $7 billion payment will not be in the spending bill.

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