Week ahead: Crunch time on push for ObamaCare fix

The coming week will be the moment of truth for a bipartisan ObamaCare fix.

Backers are pushing to have the proposal to stabilize markets and reduce premiums included in the government funding bill, which faces a March 23 deadline.

But the measure faces serious challenges that have many thinking it is unlikely to make it into the package.

The toughest challenge may be a dispute over the always-divisive issue of abortion. Republicans say restrictions on federal money going to abortion, known as the Hyde Amendment, must be applied to the new ObamaCare funds. But Democrats strongly oppose such a move, saying it would be an expansion of the restrictions into a new area of funding and would have damaging ripple effects.

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Adding to the hurdles, more conservative Republicans oppose the ObamaCare funds as a “bailout” of the law.

Meanwhile, on the Democratic side, some are now against funding payments known as cost-sharing reductions (CSRs) that are at the center of a proposal to stabilize ObamaCare markets. Because of a quirk in how the law is structured, funding those payments could have the effect of reducing subsidies that help many enrollees afford coverage.

Still, backers are pushing hard for a package of fixes to be included. In addition to the CSR payments, a measure would likely include separate payments known as reinsurance aimed at bringing down premiums.

Sen. Lamar Alexander (R-Tenn.) is one of the main champions of the proposal, arguing that it will help bring down premiums this fall.

“I’m on the floor today to say to every plumber, farmer, songwriter, and self-employed person in this country, somebody who might be between jobs, that if the Congress will act, we can lower their rates next year [by] up to as much as 40 percent,” Alexander said on the Senate floor on Thursday.  

Separately, a bill to allow terminally ill patients to try experimental drugs, known as “right to try” legislation, is on track to come back up in the House next week. The measure failed on Tuesday night under a process that requires a two-thirds majority, amid Democratic opposition. The bill would come back requiring the normal simple majority, allowing for passage in the House. The path forward in the Senate remains unclear.

The House Energy and Commerce Committee will hold a hearing to consider a range of opioid-related bills on Wednesday. It will be the second of three hearings the panel is holding in its push to bring a package of bills to fight the opioid crisis to the House floor by Memorial Day.

The Senate has also been holding hearings on the opioid crisis, as members of both parties say addressing the issue is a priority.  

One of the bolder proposals in the mix is to lift restrictions on Medicaid paying for opioid treatment at facilities with more than 16 beds. But that would come with a potentially hefty price tag, an obstacle supporters are trying to work around.

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