Democrats immediately put the onus on GOP leaders on Capitol Hill to allow a vote on legislation that would authorize the payments to insurance companies and end a years-long legal dispute over whether Congress appropriated the money in the first place. The Trump administration had couched its decision on a court ruling that Congress never explicitly authorized the payments, even though it had been making them for months before the president moved to cut them off Thursday night.
“Republicans in the House and Senate now own the health-care system in this country from top to bottom,” Schumer told reporters, “and their destructive actions, and the actions of the president, are going to fall on their backs.”
Trump’s move could increase the chances of a government shutdown in December, when Democrats might demand the inclusion of insurer payments in exchange for their votes on legislation to fund federal departments and agencies through next year. And it heightens the pressure on Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington State, who have spent weeks trying to negotiate a bipartisan compromise that would guarantee the insurer payments for one or two years while allowing states some flexibility to relax insurance regulations under Obamacare. The two senators, who are leaders of the Health, Education, Labor, and Pensions Committee, are “pretty close” to a deal, a senior Democratic aide told me on Friday. “We feel optimistic that we can get one,” the aide said, adding that an agreement could be reached in a matter of days.
The bigger, and still unanswered, question is whether Republican leaders would endorse that kind of deal and whether Trump would sign it into law. At their heart, the Alexander-Murray talks are about propping up the Affordable Care Act, while the president’s actions are aimed at unraveling the law with the hopes of bringing about its repeal.
Trump’s move to terminate what are known as “cost-sharing reduction” payments comes just three weeks before the beginning of the open enrollment period for coverage on the individual insurance market. Insurers had already locked in their rates for 2018, and Trump’s decision does not take away subsidies for people eligible for government assistance.
But because companies in many states were relying on those federal payments to make a profit, lawmakers in both parties on Friday voiced concerns that the president’s decision would prompt a last-minute rush to the exits by insurers, which could leave people in counties across the country without options to buy insurance. That would depress enrollment in the exchanges, which would likely spur more insurers to leave next year, further reducing choices and driving prices even higher.
Trump has telegraphed his intentions repeatedly, and did so again in a tweet Friday morning. Republicans have been unable to repeal Obamacare on their own, but by tipping the law into collapse, the president wants to force Democrats to the negotiating table on a replacement measure. “Dems should call me to fix!” Trump said on Twitter.