Keren Carrion

A contentious dispute over abortion is standing in the way of a rare bipartisan deal to stabilize ObamaCare.

Republicans are insisting that a rule known as the Hyde Amendment, which restricts federal money from being used to fund abortion, be applied to new funds aimed at lowering ObamaCare premiums.

{mosads}Democrats are pushing back, arguing this would represent an expansion of the Hyde Amendment to a new area of funding, preventing the government from offering money to any insurance plan that offered abortion coverage at all. 

“Make no mistake: Republicans are saying they will only agree to lower Americans’ health costs if they can strip comprehensive health coverage away from millions of women at the same time,” Henry Connelly, a spokesman for House Democratic Leader Nancy Pelosi (Calif.), said in a statement Tuesday. “Republicans are not asking to reiterate Hyde, they are trying to radically expand it to control how private insurers use private dollars.”

Republicans are holding firm, saying that the new funds being provided to insurers, known as cost-sharing reductions (CSRs) and reinsurance, must be covered by the Hyde Amendment.

“While the decision for its inclusion has not been made, any appropriation for CSRs or reinsurance would need to be Hyde compliant,” AshLee Strong, a spokeswoman for Speaker Paul Ryan (R-Wis.), said last week. “That is not negotiable for House Republicans.”

Lawmakers are running out of time to reach a deal. Supporters of the ObamaCare payments want language attached to an omnibus funding bill. Congress faces a March 23 deadline to pass that bill.

The fight over abortion is one of the last hurdles to reaching a deal on the stabilization funding, which Democrats have been advocating since last year.

In December, conservative House Republicans resisted the payments themselves as a “bailout” of ObamaCare, but since then key lawmakers have come around.

Ryan has expressed interest in the reinsurance payments in particular. Those payments help lower premiums by picking up some of the cost of especially sick enrollees. The second kind of payments, CSRs, reimburse insurers for giving discounts to low-income enrollees.

Many vulnerable House Republicans are supporting the payments, given that without them, there could be large premium increases announced in October, shortly before the November midterms.

Sen. John Thune (S.D.), the No. 3 Senate Republican, on Tuesday said the CSR payments could be included in the funding bill, but acknowledged the abortion issue remains unresolved.

“I think that’s a possibility, yeah,” Thune said.

Asked about the Hyde issue, Thune said, “Obviously we want to get the Hyde language in there, for sure.”

Sen. Lamar Alexander (R-Tenn.) said Tuesday that Republicans simply want to apply the same Hyde language that has long been included in government funding bills to the ObamaCare payments.

Other Republicans are seeking to pressure Democrats to drop their demands, casting them as putting abortion rights above the needs of constituents who would be helped by the health-care language.

“I’m surprised to hear that some Democrats may object to my bill because they want taxpayer dollars to be used to pay for abortions rather than what it is intended to do, which is lower health insurance premiums for low and middle income families,” Rep. Ryan Costello (R-Pa.), the lead sponsor of the House bill, said in a statement.

Costello faces a difficult reelection race this fall in a district recently redrawn by his state’s Supreme Court in a way that benefits Democrats.

Further complicating matters, liberal health-care groups like the advocacy organization Families USA are now pressuring Democrats not to fund the CSR payments. Because of a quirk in the way ObamaCare is structured, funding the CSR payments could actually raise costs for some enrollees because it would result in a reduction in the subsidies that help people afford coverage.

Some on the left therefore support the reinsurance payments but not the CSRs.

Alexander, though, said Tuesday that he is still pushing for both CSRs and reinsurance, as well as additional flexibility for states to change ObamaCare rules.

“We’re working hard to try to include it in the omnibus next week,” he said.

Tags John Thune Lamar Alexander Nancy Pelosi Paul Ryan Ryan Costello

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