Is ObamaCare worth saving? That’s the question before Congress as they debate new funding for this failing healthcare system.
Congress is considering an omnibus-spending bill and, as usual, unpopular spending is being weighed against spending everyone likes. The issue is CSRs, cost-sharing reductions, which are payments to insurance companies to defray out-of-pocket expenses or deductibles for low-income individuals.
These CSRs were approved by the Obama administration without Congressional appropriation so a federal judge declared them illegal. The Trump administration stopped the practice last year.
But the issue has come up again as insurers threaten large premium increases that will be announced just before the 2018 mid-term elections. GOP lawmakers are hesitant to give Democrats a campaign issue they can use against them.
The Wall Street Journal editorial board says moderate Republicans are demanding a “stability” deal for ObamaCare as the price of repealing the law’s penalty for declining to purchase health insurance in the tax bill (The Individual Mandate). That deal included billions in cost-sharing payments as well as reinsurance, which subsidizes high-cost patients to lower premiums for everyone else.
But the numbers have sky-rocketed since the last proposal. Last year Maine Republican Susan Collins proposed $5 billion over two years. This time the proposal is $30 billion over three years.
The problem is Democrats wrote the law to make sure insurers got paid one way or another. Premiums are higher without the cost-sharing payments so insurers benefit. The law’s tax credits grow in generosity as premiums rise, so the taxpayers pay the higher cost. Either way insurers get paid.
To add insult to injury, insurers are “Silver loading”, increasing premiums especially on Silver plans because these are tethered to the tax credits. In reality, the ultimate cost to the taxpayers is actually less when making the CSRs than allowing the tax credits to rise. Bizarrely, some left-wing advocates now oppose the CSRs they previously demanded because the tax-credit formula is more lucrative!
Then there is the Hyde Amendment, which blocks taxpayers’ dollars from funding abortions. The Trump administration and Speaker Paul Ryan have taken a stand to defend this amendment, but Democrats are trying to bully them into submission to get a deal. Apparently the abortion lobby isn’t satisfied with the hundreds of thousands of abortions already performed every year – and the half-billion in federal funding of Planned Parenthood, the nation’s largest abortion provider.
Republicans will rue the day if they give in on the Hyde Amendment. Although abortion providers have found many ways around Hyde, the symbolic message sent with a GOP defection on this principle would be devastating to their November chances. It’s time to make Democrats choose between abortions and funding the favorite achievement of the Obama presidency – ObamaCare.