Funding deal blocks Trump ObamaCare moves, repeals health taxes

The government funding deal poised to pass Congress this week would block President Trump from taking major actions to “sabotage” ObamaCare and would fully repeal three taxes in the health care law, according to a senior House Democratic aide.

The bipartisan deal would prevent Trump from taking what Democrats called “sabotage nuclear options” against ObamaCare. Specifically, that means the law will prevent Trump from unilaterally ending a workaround called “silver-loading,” which helps insurers compensate for the loss of key ObamaCare payments and has the effect of giving greater financial assistance to many ObamaCare enrollees. 

Democrats had been worried Trump could end the practice in a bid to cause harm to the law. In addition, the deal will prevent Trump from ending automatic reenrollment in ObamaCare plans, whereby if enrollees do not actively choose a new health insurance plan for the new year, they are automatically reenrolled to their current plan.

On a separate front on ObamaCare, the spending deal repeals three major taxes that had helped fund the law’s coverage expansion. The deal will repeal a 40 percent tax on generous “Cadillac” health plans, the 2.3 percent medical device tax and the health insurance tax.

Those are major wins for the health insurance and medical device industries, which had long lobbied to lift those taxes. The Cadillac tax, in addition to providing about $200 billion in funding over 10 years, had been intended to help lower health care spending by incentivizing employers to lower costs to avoid hitting the tax. But the idea was opposed by unions and employers who did not want their health insurance plans taxed, setting up a broad bipartisan coalition against the idea.

The deal notably does not include a bipartisan measure to protect patients from surprise medical bills, despite a push from backers. That measure is mired in internal fighting among lawmakers and fierce lobbying by doctors and hospitals.

There are also not any major provisions included that would lower drug prices.

House Democratic leaders are hoping there will be another chance to enact those priorities early next year, given that the deal sets up a May 22 deadline for renewing a range of expiring health programs like community health center funding. That deadline will create another must-pass health care bill that Democrats hope can include drug pricing and surprise billing measures.

The deal does include one relatively small bill to lower drug prices, called the Creates Act, which cracks down on drug companies gaming the system to delay the introduction of cheaper generic competitors.

The measure also raises the legal age to purchase tobacco to 21.

Drug pricing advocates had fought for years to pass the bill, which was long opposed by the pharmaceutical industry. It is a sign of at least a small shift in the drug pricing debate that the measure is now passing.