House Speaker Paul D. Ryan said Thursday the Trump administration will continue to reimburse insurers under Obamacare while it settles on a repeal plan, though health plans swiftly demanded a longer-term commitment.
House Republicans had won a ruling last year that President Obama was breaking the law by making the payments to insurance companies, which help low-income customers with deductibles and other out-of-pocket costs, even though Congress had specifically canceled that money.
The Trump administration could easily drop Mr. Obama’s appeal of the ruling, but the White House and Republicans now realize they may have to keep the payments flowing until they figure out how to get rid of Obamacare and dispose of the suit.
“While the lawsuit is being litigated, then the administration funds these benefits. That’s how they’ve been doing it and I don’t see any change in that,” Mr. Ryan said at his weekly press briefing.
Mr. Ryan said the lawsuit goes beyond Obamacare — the House sued to retain their power over the nation’s purse strings.
Yet with Mr. Trump in charge of the Justice Department, the main impediment to moving forward is a rift within the GOP, which failed to rally around a bill last week that would have dismantled Obamacare, while avoiding a Democratic filibuster later on.
“Our plan A here is to repeal and replace Obamacare and have that transition occur where these markets are stabilized. And that’s what we hope to achieve,” Mr. Ryan said.
Millions of Obamacare customers with incomes between 100 percent and 250 percent of poverty rely on the cost-sharing payments and — with repeal on hold for now — health plans are still required to reduce their out-of-pocket costs whether they’re reimbursed or not.
If the payments went away, companies would likely raise their premiums to make up the difference. If that happened, Mr. Trump would be accused of sabotaging the market.
America’s Health Insurance Plans, a major insurers’ lobby, said plans mulling whether to stay in the individual market need to know whether the payments will continue beyond this year.
“While the lawsuit does remain in abeyance right now, it’s very important we receive some indication from Congress and confirmation that [the payments will be made] through 2018,” AHIP spokeswoman Kristine Grow said.
Insurers must decided by June 21 whether to participate in the federally run Obamacare exchange known as HealthCare.gov.
“There is still time, but we do need swift action on these,” Ms. Grow said.
AHIP says it doesn’t care what mechanism the government uses to make the payments, which will cost an estimated $130 billion from 2016 to 2026, according to the Congressional Budget Office.
U.S. District Court Judge Rosemary Collyer had said the cost-sharing payments must stop until Capitol Hill explicitly appropriates the money, though she stayed her ruling pending the appeal.
The payments are effectively on autopilot for now, though key Republicans say they would like to pass a repeal bill and authorize the money during a multi-year transition to the new system.
“My preference is it would be appropriated. That would be the most legal way to do it,” Energy and Commerce Committee Chairman Greg Walden, Oregon Republican, said. “The Obama administration, as determined by the courts, was spending money without authority. It was illegal.”
Democrats see the payments as a bellwether for the Trump administration’s eagerness to uphold Obamacare while it struggles to rally the fractious House GOP caucus around a repeal-and-replace strategy.
“They have to enforce the law. They said it’s the law of the land,” House Minority Leader Nancy Pelosi said Thursday.
The California Democrat said failure to reimburse insurers or enforce the individual mandate requiring American to get insurance or pay a tax would hasten Obamacare’s demise and be be “totally irresponsible.”
“But they want it to be a self-fulfilling prophecy,” Mrs. Pelosi said.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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