House Speaker Paul Ryan told reporters Wednesday that the spending bill that would avoid a government shutdown would not include payments critical to keeping the Affordable Care Act’s health-insurance markets viable.
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PAUL RYAN: The deal to avoid a government shutdown will not include payments needed to avoid Obamacare collapse
Paul Ryan said "we're not doing" cost-sharing reduction payments in the spending bill, throwing the future of the Affordable Care Act's exchanges into doubt.
House Speaker Paul Ryan.
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Democrats had hoped to include cost-sharing reduction payments in the spending bill to ensure the stability of the individual insurance exchanges and therefore of the Affordable Care Act, the healthcare law better known as Obamacare.
"CSRs, we're not doing that," Ryan told reporters a press conference with House GOP leadership. "That is not in an appropriation bill — that's something separate that the administration does."
While Congress could fund the CSR payments via a new appropriation, the White House currently controls the CSR spending — though its authority to do so is under dispute in the court system.
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CSR payments go to insurers to help defray the cost of offering plans to low-income Americans. Without the roughly $8 billion in annual payments, many health-policy experts have said, the marketplaces would see a flood of insurer exits and steeper price increases for Americans getting insurance through the marketplaces.
The payments are the subject of a lawsuit between the Republican-controlled House of Representatives and the Department of Health and Human Services that dates back to the Obama administration. The House argued the program was illegal since the funds were not appropriated by Congress. A judge ruled in Congress' favor in 2016, but an appeal from the Obama administration is still pending.
President Donald Trump has discussed the possibility of dropping the payments if they are not appropriated by Congress, injecting massive uncertainty into the Obamacare exchanges and insurers' plans for 2018.
Whether Democrats demand that CSR payments be included in any spending legislation could decide whether the bill passes and a government shutdown is avoided this week. Forty-two percent of people surveyed in a Politico/Morning Consult poll said the continuation CSR payments were important enough to prompt a government shutdown.
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