Dems, not trusting Trump, want permanent ObamaCare fix

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Rank-and-file Democrats in the House aren’t satisfied with President Trump’s offer to make critical ObamaCare payments as part of a deal to keep the government funded and prevent a shutdown.

They’re seeking a permanent legislative fix to the issue, something they believe would stabilize the healthcare law.

And they say they don’t trust Trump to stick to his word in making the payments, which if withheld could cause havoc in ObamaCare’s exchanges.

“Whenever he says, ‘Take me at my word,’ it’s going to worry every Democrat in the House,” Rep. Emanuel Cleaver (D-Mo.) said of Trump. “And probably even people who vote for it understand that the president’s word changes like Washington weather.”

Rep. G.K. Butterfield (D-N.C.) echoed that concern, questioning whether Trump’s commitment is “binding.”

{mosads}The payments to insurers, known as cost-sharing reductions (CSRs), have been made by the executive branches under both Trump and Obama to offset losses to companies that provide care to low-income consumers.

If the payments end, companies would be barred from charging these consumers deductibles, but it could cause them to pull out of the market, reducing access to healthcare for the poor. People who make between 100 percent and 250 percent of the poverty line are eligible for the assistance.

House Republicans sued the Obama administration over the payments, arguing that Congress never appropriated them and that they are unconstitutional. The House GOP won an initial court decision, and the Trump administration has to decide whether to appeal.

Trump previously has suggested he could end the payments or use them as leverage in talks aimed at getting Democrats to agree to changes to ObamaCare.

But this week, Trump sought to defuse threats by Democrats to withhold support for a spending bill over the issue by saying that he would continue to make the payments.

Senate Minority Leader Charles Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) accepted Trump’s offer.

But other Democrats want more: a permanent fix. And they say they may not support the government spending bill if it excludes specific language guaranteeing the payments. 

“If I don’t have confidence that President Trump will continue the payments, I won’t even consider voting for it,” Butterfield said of the spending bill. “I need some reassurance from the administration, some type of declaration not just from the president but from the whole administration — from the secretary on down, [Mick] Mulvaney and the rest of them.”

An erosion of Democratic support for an omnibus spending bill would complicate passage of the legislation, as GOP leaders are expected to need a significant number of Democratic votes to move the spending package through each chamber. 

Congress on Friday passed a stopgap measure to fund the government for seven days, but lawmakers are still haggling over a larger package to extend the funding through the remainder of fiscal 2017, which runs through September. A failure to act by the end of next Friday (May 5) would shutter much of the federal government.

House Speaker Paul Ryan (R-Wis.) has rejected the idea of including funding for the payments in the spending bill — “We’re not doing that,” he said.

How long the payments will continue, however, remains unknown.

“While we agreed to go ahead and make the CSR payments for now, we haven’t made a final decision about future commitments,” a White House official said in an email.

The lack of certainty is the reason some Democrats are now pressing to secure the subsidies as part of the current spending debate.

“The problem is they’re going to pay April’s payments and then May’s payments are coming up May 20, and you can’t run a health plan on a month-by-month basis. So that’s why this is a critical issue,” said Rep. Ami Bera (D), a California physician. 

“At a minimum we ought to guarantee those payments for five years, if not make them permanent. The omnibus would be the right place to do that.”

The House Democrats are not alone in their concern. Sen. Patty Murray (D-Wash.), ranking member of the Senate Health, Education, Labor and Pensions (HELP) Committee, is also dubious about Trump’s commitment to the payments.

“[A] short pause in this Administration’s saber-rattling isn’t enough to calm the uncertainty they’re causing in our health care system,” Murray said in a statement.

Both Schumer and Pelosi on Friday defended their decision to accept Trump’s offer without legislative assurances to back it up.

“They understand that the public knows that if they renege on this commitment, that premiums will go up. It’s going to cost the federal government more. It’s not a good idea,” Pelosi said. “I think we’re in a good place with them on this.”

Schumer also downplayed the threat that the payments would cease.

“The same forces that forced them to say ‘yes’ the first time are still going to be in effect for quite a while,” he said.

Many Democrats will almost certainly adopt the position of their respective leaders when the spending package hits the chamber floors. Rep. Marc Veasey (D-Texas), for instance, said he trusts Pelosi’s negotiating prowess enough to follow her lead on the omnibus vote.

“Nobody knows how to make a deal better than Nancy,” he said. “This is her wheelhouse.”

Yet other Democrats suggested their leaders have placed too much weight on Trump’s promise to continue the subsidies — payments, they argue, he was legally obligated to make to begin with.

“The president is not giving us something or doing us a favor by doing what he is supposed to do, which is to keep the insurance markets from being totally freaking wrecked,” said Rep. Ruben Gallego (D-Ariz.). “So if that’s what we believe we should be getting out of leadership, or through our leverage, then we just miscalculated.”

It’s unclear how many Democrats might hinge their votes on the fate of the CSR language. Party leaders have vowed not to instigate a government shutdown, and they’ll face plenty of pressure to provide votes if they get what they want on other issues, such as women’s reproductive health, consumer financial protection and healthcare in Puerto Rico. 

With so many parts still in motion, even the harshest Trump critics are keeping their powder dry on the omnibus vote.

“I need to see what the leadership is going to say,” Cleaver said, referring to the ObamaCare subsidies. 

“That doesn’t mean I’m going to follow them, but maybe they have a level of comfort that I don’t presently share.”

Scott Wong contributed.  

Tags Ami Bera Charles Schumer G.K. Butterfield Patty Murray Paul Ryan
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