Republicans are weighing whether to use a complicated budget maneuver to help pay for additional ObamaCare funding, sources say.
The idea being considered by House Republican leaders is controversial because it would help fund key ObamaCare payments to insurers, something that many conservatives decry as a “bailout” of the law.
Under the possible plan, the House Budget Committee would direct the Congressional Budget Office (CBO) to take ObamaCare payments to insurers known as cost-sharing reductions (CSRs) out of its “baseline” for projecting federal spending. Essentially, the agency would stop assuming that the ObamaCare payments would be made.
{mosads}That shift by the CBO would unlock the second step of the Republican plan. If they subsequently proposed making the CSR payments, the CBO would then score the proposal as saving the government money. Those savings could then be used to pay for additional ObamaCare stability funding, known as reinsurance, to bring down premiums.
(Making the ObamaCare payments would save the government money because it would cause premiums to fall. When premiums fall, the government pays less in financial assistance to ObamaCare recipients.)
While the process would be complex, the end result would be simple: It would allow Republicans to fund the ObamaCare payments without having to find a budget offset to pay for them.
Some conservatives are opposed to the maneuver, calling it a “budget gimmick,” so it’s far from certain that the plan can win support from the House GOP conference.
Still, it’s clear that GOP leaders are giving serious thought to the possibility of making the controversial ObamaCare payments as part of the government funding bill that must pass by March 23 to avoid a shutdown.
Sources say Speaker Paul Ryan (R-Wis.) is interested in the plan, given that it provides a way to pay for the reinsurance funding, which he has spoken favorably of in the past. Ryan said at an event in Wisconsin in January that he thought there is a “bipartisan opportunity” to provide that funding and bring down premiums.
Ryan’s office did not respond to a request for comment.
House Budget Committee Chairman Steve Womack (R-Ark.) told The Hill on Monday the idea of getting the CBO to change its baseline had been “floated” but declined to comment further.
Democrats have been pushing for the CSR payments and the reinsurance funding for months. Republican Sens. Lamar Alexander (Tenn.) and Susan Collins (Maine) have also been pushing for the funding.
The main holdup when the issue was debated in December was the House, given that conservatives there are dead-set against anything they consider a “bailout” of health insurance companies.
The resistance among top House Republicans to the stability funding appears to be lessening, but rank-and-file conservatives remain an obstacle.
“I view it as a bailout of the insurance companies,” Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, told The Hill on Wednesday when asked about the CSR payments.
Asked if the inclusion of the ObamaCare payments would make it hard for a government funding bill to pass the House, Walker said, “I think having that in there makes it more difficult, I’ll put it that way.”
However, it is possible that conservative votes would not be needed to pass the funding bill through the House. The bill, known as an omnibus, could attract substantial Democratic support, given that it will be the byproduct of a bipartisan spending deal.
Some conservatives are also pushing back on the idea of forcing the CBO, a nonpartisan budget scorekeeper, to change its baseline.
“This is a huge budgetary gimmick,” said Chris Jacobs, a conservative policy analyst who worked for Vice President Pence when Pence was a member of Congress. “Republicans should be ashamed of themselves for even considering it.”
However, Doug Holtz-Eakin, a former director of the CBO who is now president of the right-leaning American Action Forum, said it makes sense for the CBO to reflect reality, which is that President Trump has canceled the CSR payments and they are no longer being paid.
He said the decision is up to the Budget committees in the House and Senate.
“It’s not really CBO’s call,” he said, adding that in this case, “Budget committees direct the score.”
Even with the budget maneuver, there are still major obstacles to the ObamaCare funding. One is a dispute over abortion. Republicans say restrictions on federal funding for abortion known as the Hyde Amendment must be applied to the ObamaCare funding, but Democrats are certain to oppose such a proposal.
Democrats are also pushing for additional measures like expanding ObamaCare subsidies that help people afford premiums to make them more generous, but Republicans are skeptical of that push.