Partisan politics and emerging conservative proposals could derail bipartisan congressional efforts to pass a bill that stabilizes the Affordable Care Act's insurance marketplaces.
Republicans now want to fully defund Planned Parenthood in a healthcare spending bill, which must be passed by March 23, Politico reported. Democrats, predictably, have pledged to block conservative additions to the bill, which also include ending a federal family planning program and cutting the Teen Pregnancy Prevention Program.
Sen. Patty Murray, of Washington, one of the Democrats leading the bipartisan healthcare talks, said last week in a statement to the outlet that these riders could bring the discussions to an abrupt end.
"I've consistently made clear that undermining women's health and expanding restrictions on women's access to the full range of reproductive healthcare—including at trusted providers like Planned Parenthood—is a complete nonstarter," Murray said.
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Rep. Ryan Costello, R-Pa., who sponsors the House's stabilization package, shot back at the criticism, saying that if the Democrats want to block the bill "by playing abortion politics, then shame on them," the Associated Press reported.
AshLee Strong, spokeswoman for Speaker Paul Ryan, told the AP that any stabilization bill must comply with policies imposed by the GOP that prevent the use of federal funds on abortion in almost all cases.
"That is not negotiable for House Republicans," she said.
Two bills are on the table in the Senate, one led by Murray and Sen. Lamar Alexander, R-Tenn., which would revive cost-sharing reduction payments among other provisions, and a second from Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., which would fund a reinsurance program.
The bill Costello has introduced in the house is similar to the Collins-Nelson measure.
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President Trump’s plan to sabotage bipartisan negotiations is just his latest effort to sabotage families’ health care in ways that are particularly damaging for women. https://t.co/wrdvwrlyET
— Senator Patty Murray (@PattyMurray) March 10, 2018
Another factor throwing a wrench into the proceedings is that funding CSRs may hurt the markets, according to a new report from the Center on Budget and Policy Priorities, a left-leaning think tank.
Because insurers have adapted to work in the individual markets without the payments, restoring them without adjusting subsidies—a proposal that Murray has backed—could instead lead to premium hikes, according to the report. This trend would have the opposite effect the bills intend, and would further weaken the markets.
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The group also warns that a GOP proposal to fund reinsurance but offset the costs by restoring CSRs could prove harmful. The plan would make it easier for people making 400% or more of the poverty level to acquire insurance but would do so by curbing access for those making 400% or less of the poverty level, according to the report.
The White House has offered mixed messages on CSRs, further compounding the confusion.
Last week, a leaked memo said that President Donald Trump would support funding the payments beyond 2018, but in a statement a White House spokesman said the administration could not support what would amount to "a bailout to insurance companies."
The president's proposed 2019 budget accounts for a full ACA repeal, but includes funding for CSRs and the law's risk corridors, which rankled conservatives who oppose both.
The other requests in the memo could complicate the talks, too, as the Trump administration has requested a change to the ACA's rate-banding rule to allow insurers to charge older people five times as much as they charge younger people.