Republicans are barreling toward the upcoming Obamacare enrollment period without a unified plan to address the sticker shock that millions of Americans are likely to experience due to the expiration of key federal subsidies.
The lack of direction comes from the top, with President Donald Trump not providing clear guidance to his party on how he wants to deal with the expiring subsidies that could result in dramatic out-of-pocket price hikes for enrollees.
Rep. Jeff Van Drew (R-N.J.) said he spoke to the president on the phone about a week ago to talk about a yearlong extension of the enhanced subsidies. He said Trump asked him: “Can’t we do something better?” But Van Drew said he replied, “Mr. President, we don’t have the time.”
Trump’s lack of urgency in extending the subsidies and his interest in a major health care overhaul — as he has now mentioned in a private meeting with Democratic leaders as well as with Republicans — is complicating GOP leaders’ efforts to address expiring health insurance subsidies that affect 20 million Americans without fully repealing Obamacare, according to four Republicans granted anonymity to disclose private deliberations. Hill Republicans will need Trump’s sign off to do anything with the Affordable Care Act subsidies, and they’re starting to run short on time.
On Nov. 1, most consumers can start shopping for next year’s ACA plans. But without legislation to extend the enhanced subsidies beyond this calendar year, those plans will appear on enrollment websites as substantially more expensive than this year’s out-of-pocket costs.
Press secretary Karoline Leavitt was noncommittal Thursday about what the president would do to address the potential spike and demanded Democrats first vote to reopen the government.
“I’ll just point out the irony in Democrats holding the government and the American public hostage over a health care system that they created,” Leavitt said. “Republicans have always said it’s a broken system, yes, but [Democrats] caused it, and now they want to shut down the government to fix it.”
Hers is a view shared by some in the president’s orbit. Many don’t believe Trump needs to embark on a rescue mission to save former President Barack Obama’s health law.
“I don’t think the president cares to save Obama’s legacy legislation that has proved to be a failure and an ongoing headache for everyone involved,” said a person familiar with the administration’s thinking, granted anonymity to discuss sensitive issues. “I do see a scenario where the president sees a pathway for a health care policy bill that could receive some bipartisan support.”
The expiration is largely not a swing state issue, but more of an issue in lower-income, deep-red districts where Trump has a loyal base of supporters, the person said.
“This isn’t a [Rep.] Mike Lawler problem, funny enough, it’s a [Rep.] Marjorie Taylor Greene issue. They have room to weather the storm,” the person said, adding a note of caution: “But if constituents are being hurt because they are less fortunate on health care, there needs to be an answer to that.”
Republicans in the White House and Capitol Hill have no plans to change that strategy, confident that Democrats will blink and face blame for the funding lapse. Republicans also feel they’re making headway with the message that Obamacare is in need of rescue, because, as they argue, it’s grown too expensive and is failing Americans.
A person close to the White House, granted anonymity to describe administration officials’ thinking, said the GOP message will be focused on exposing Obamacare’s expense — and placing blame on Democrats for sunsetting the subsidies in a 2022 law they passed on party lines, the Inflation Reduction Act.
“Democrats have to be really careful, because they’re going to get exposed on one, how expensive Obamacare is,” the person said. “And two, they were the ones that put that in the Inflation Reduction Act, where the subsidies sunset.”
GOP leaders are trying to keep in pace with the White House and ensure Trump doesn’t give in to Democrats’ demands to negotiate a way out of the shutdown. The president this week, after a call with Senate Majority Leader John Thune and Speaker Mike Johnson, reinforced their message that he would meet with Democratic leaders but only after they reopen the government.
Still, Republican leaders and White House officials are ramping up behind-the-scenes talks on a potential subsidies extension with conservative reforms paired with other health care policies, which would need bipartisan support to pass in Congress.
While congressional Republicans aren’t feeling pressure from Trump, some argue they also aren’t feeling pressure from constituents at home yet about the expiring subsidies.
“Right now my sense is that the vast majority of Republicans feel very little political pressure on the enhanced subsidy issue,” said a senior GOP staffer who was granted anonymity to speak candidly. “Our phones are mostly quiet, which is a clear sign Democrats’ claims aren’t convincing.”
But a swath of Republicans are getting an earful from constituents — and are getting antsy about an ACA extension deal, albeit with new restrictions on the subsidies.
“If it’s not too late, it’s damn close,” Van Drew said about finding a solution without disruptions during ACA open enrollment, which begins Nov. 1. Van Drew said that he argued to the president to extend the tax credits for a year to buy time for a better solution.
“For one year, let’s really work hard on this and come up with something innovative,” he said. The president told him he understood and that he would look into it, Van Drew said.
Some Republicans are also privately discussing the need for Congress, or Trump, to act to extend the window for open enrollment — especially to protect some of their most vulnerable Republicans up for reelection.
Johnson didn’t rule out that possibility in a brief interview Wednesday, simply saying he would not forecast any outcome at this point.
He indicated, though, it was on Republicans’ radar.
“If we can get the government reopened, we have lots of thoughtful discussion to have on that and other issues,” Johnson added.
Other Republicans who are in touch with health insurance companies suggest insurers could recalibrate premiums based on a deal that happens after Nov. 1.
“I don’t think it’s too late. I mean, I think the beautiful thing about modern technology is you can make adjustments,” Rep. Mike Haridopolos (R-Fla.) told reporters this week. “And these insurance companies are very sophisticated, and they’ll be able to run these numbers off the bill very quickly.”
