Conservatives decry Trump budget's call to fund risk corridor, CSR programs

Though President Donald Trump’s 2019 budget proposal calls on Congress to repeal the Affordable Care Act, it also seeks mandatory funding for two ACA programs: risk corridors and cost-sharing reduction payments.

Conservatives, who have characterized both programs as bailouts for insurance companies, aren’t pleased.

“The Trump administration was absolutely right when it called this corporate welfare a ‘payoff to insurance companies’ that was ‘terrible policy,’” said Nathan Nascimento, executive vice president of the right-wing think tank Freedom Partners. “We urge Congress and the Trump administration to remember why they opposed these payoffs in the first place.”

RELATED: Trump budget calls for ACA repeal, cuts to Medicare and Medicaid

Republican Sen. Marco Rubio expressed a similar view, saying in a series of tweets that there is no justification for shielding risk corridor payments from automatic cuts, yet not programs that matter to his home state of Florida.

As he alluded in his tweets, Rubio has waged a years-long campaign against the temporary risk corridor program, which made payments to ACA exchange insurers with costs that exceeded a set amount and charged insurers with costs below that baseline.

Rubio helped add a provision to an omnibus spending bill that prevented the program from paying out more than it took in—even if collections fell short. Because what the government owes insurers has always exceeded what it collects, its unpaid balance has now swelled to $12.3 billion.

Insurers have responded by suing the government to recover the unpaid funds, and with at least two securing favorable judgments. Some ACA exchange carriers have also filed suit, incidentally, to recover unpaid cost-sharing reduction (CSR) payments after the Trump administration stopped funding them last fall.

Though conservatives may not be pleased with the idea of appropriating funding for those subsidies, doing so would actually align with House Republicans’ reason for pursuing a legal case against the CSR program. That case, which the parties settled in December, centered on whether the Obama administration was breaking the law by funding the subsidies without Congress’ approval.

Meanwhile, there have been bipartisan efforts in Congress to appropriate temporary funding for CSR payments in the interest of stabilizing the ACA’s individual insurance markets. So far, though, they’ve been unsuccessful.