Vulnerable House Republicans are getting caught in the crossfire as a partisan battle over $7 billion in Obamacare funding rages.
President Trump is threatening to cut off federal subsidies that benefit middle class Americans who access health insurance through the Affordable Care Act — unless Senate Democrats agree to fund a security wall along the Southern border.
Congressional Republicans have little desire to prop up Obamacare. But these subsidies, or “Cost Sharing Reductions,” flow to perhaps hundreds of thousands of Americans who live in districts represented by Republicans considered soft targets for the Democrats in 2018.
Rep. Carlos Curbelo, R-Fla., is a prime example. He’s defending a district that voted for Hillary Clinton over Trump by nearly 17 percentage points. He is sure to be a top Democratic target next year. More than 70,000 people who benefit from CSR subsidies live in Curbelo’s district.
The subsidies are technically payments to insurance companies. The arrangement enables insurers to offer coverage at reduced rates to Americans who earn too much to qualify for Medicaid but can’t afford healthcare at market prices.
If Republicans and the Trump administration don’t finance the subsidies in a spending bill that must pass by April 28 to avoid a government shutdown, the GOP could face a voter backlash as insurers cancel plans and pull out of communities.
“Republicans wanting Obamacare to collapse might be a good talking point in 2017, but it will be disastrous at the ballot box for us in 2018,” a former House GOP aide said. Republicans interviewed for this story requested anonymity in order to speak candidly.
After months of negotiating, the White House and Republicans on Capitol Hill have not reached an agreement on legislation to repeal and replace former President Barack Obama’s health care law.
That has put them in an awkward position. They either protect Obamacare from implosion, or risk the ire of voters whose premiums would spike, and choices diminish, even more than has already occurred under the troubled Affordable Care Act.
Trump’s offer to the Democrats for a dollar-for-dollar trade in border wall and Obamacare subsidy funding was made Friday via a television interview with White House budget director Mick Mulvaney. A spokesman for Senate Minority Leader Charles Schumer, D-N.Y., said it was a nonstarter. The White House referred a request for comment to Mulvaney’s office.
House Republicans with Democratic targets on their back could come under servere political pressure in the midterm if the issue isn’t resolved.
They include Rep. Will Hurd of Texas, whose district voted for Clinton over Trump by 3.4 points and includes 21,000 people benefiting from CSR subsidies; and Rep. Barbara Comstock of Virginia, whose district voted for Clinton by 10 points and includes 22,500 beneficiaries. The figures were compiled by Democratic committee staff in the House.
A GOP strategist who advises congressional Republicans warned that voters would give them some time to address the problem, “but not forever.” Indeed, the party could face an immediate test in Georgia and Montana, where it is defending vacant, conservative leaning House seats in competitive special elections.
In the suburban Atlanta 6th district, more than 25,000 people purchase health insurance subsidized by Cost Sharing Reductions under Obamacare. In Montana’s statewide, at-large district, 23,500 people depend on subsidized plans.
Voters head to the polls in Montana on May 25, and in Georgia on June 20. Insurers are prepared to drop plans and pull out of markets dependent on the subsidies beginning early next month if a deal isn’t reached guaranteeing their continuity.
Recent public opinion polls reveal low marks for Trump’s handling of healthcare — as well as the GOP proposal to partially repeal and replace Obamacare that is stalled in the House. A loss of CSR subsidies could roil these closely watched special elections and tip them toward the Democrats.
“Democrats will highlight it and make it worse than it is,” warned a Republican operative who advises the insurance industry.
Meanwhile, targeted House Republicans from Clinton districts aren’t the only GOP members who might be affected. Conservatives from safe red seats, whose constituents are strong supporters of the president, also would be impacted.
Rep. Mark Meadows, chairman of the House Freedom Caucus, is one of them. The group of Republicans he leads is pushing for a more aggressive overhaul of Obamacare’s regulatory regime than that supported by House GOP leadership and the White House.
Yet, more than 29,000 people with plans subsidized by CSRs live in Meadows’ western North Carolina district. Rep. Raul Labrador, R-Idaho, another prominent Freedom Caucus member from a solid conservative district, represents nearly 29,500 people who benefit from the federal subsidy.
Under Obama, the administration maintained the subsidies even though it wasn’t clear it had the statutory authority to do so. House Republicans sued, and won, but the judge’s decision was stayed pending appeal.
House Republican leaders and the Trump administration have been considering paying for the CSRs in the government funding bill to ensure that insurance companies won’t cancel plans and pull the rug out from under thousands of Americans.
“The issue is on the table but currently under negotiation,” a House Republican aide said.
Robert King and Kimberly Leonard contributed to this report.
