Refusing to accept defeat on ACA repeal, Trump poised to decide fate of CSR payments

Donald Trump speaks at healthcare lunch
President Donald Trump issued a series of tweets this weekend that urged Senate Republicans to keep fighting to repeal the ACA.

Though Republicans’ plans to repeal the Affordable Care Act have failed resoundingly, President Donald Trump and his administration are making it clear they’re not giving up the healthcare policy fight.

The president’s next move—his decision whether to continue cost-sharing reduction payments to health insurers—could come very soon, White House Counselor Kellyanne Conway said Sunday.

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“He's going to make that decision this week, and that’s the decision that only he can make,” Conway said on “Fox News Sunday.”

Trump himself implied as much in a tweet this weekend, threatening to end “bailouts” for both insurance companies and Congress.

Conway confirmed that the former “bailout” refers to the CSR payments. Trump’s threat against the latter “bailout” means he wants Congress to bear more of the burden for their subsidized health insurance if they fail to repeal and replace the ACA, Office of Management and Budget Director Mick Mulvaney said on CNN’s “State of the Union” on Sunday.

Regarding another tweet of Trump’s, in which he implored Republican senators to “demand another vote before voting on any other bill!” Mulvaney confirmed that the White House believes the Senate shouldn’t vote on any other measure until holding another vote on healthcare.

Conway concurred, saying on Fox that “the president will not accept those who said it’s ‘time to move on.’”

It’s unclear, however, whether Senate Majority Leader Mitch McConnell is actually gearing up for another ACA repeal attempt. In his remarks early Friday morning after the Senate GOP’s third attempt at repealing the law failed, he seemed more resigned to defeat than defiant.

Department of Health and Human Services Secretary Tom Price, meanwhile, said this weekend on “Meet the Press” that his agency will “follow the law of the land” when it comes to the ACA—but he also made the point that the law is failing the American people.

HHS’ goal, like Trump’s, is “to put in place a law, a system, that actually works for patients,” he said, noting that can’t be accomplished through regulation, but instead requires Congress to repeal and replace the law.

HHS can take certain steps to undermine the ACA, however—and it has already taken some. Earlier this month, the agency ended contracts with two companies that helped provide customer assistance during open enrollment. It has also used funding set aside for promoting the ACA to mount a PR campaign against the law and halted an advertising campaign during the previous open enrollment period.