Caitlin Owens

GOP chairman: Remember that insurer subsidy lawsuit?

Lauren Victoria Burke / AP

Rep. Mark Walker hasn't forgotten about the pending House lawsuit challenging the legality of Affordable Care Act insurer subsidies — the very same ones the Trump administration said Wednesday they'll continue to pay for the time being. A district court judge has ruled in favor of the House, but the Obama administration had appealed the decision.

"Congress has made no appropriation for Obamacare cost sharing reduction payments," Walker said in a statement. "We believe making these payments without congressional approval is both clearly illegal and unconstitutional."

The continued payments, which bring down the costs of deductibles and out-of-pocket costs for low-income exchange enrollees, have widely been received as a way to keep a fight over the subsidies from shutting down the government. Democrats have eased off their demands for putting the funding in the spending bill currently being negotiated.


House, White House considering Friday health care vote

Evan Vucci / AP

There is now discussion on the Hill and in the White House about a health care vote this Friday. The House whip team is busy counting moderate votes and gauging support within the caucus, and there should be a clearer picture of where things stand tonight.

A Friday health care vote isn't "outside the realm," Republican Study Committee Chairman Mark Walker told Axios, adding that people are discussing a Friday vote and things are "even trending that direction."

"Most of them like what they see, so we're considering to grow the vote, and when we're ready, we'll move," said House Majority Whip Steve Scalise.

Yes, but: Both the White House and GOP House leadership are cautious about setting artificial deadlines. That's what they did last time and it backfired. They believe a vote this week is possible, though they're unwilling to say "likely."


Trump tax plan repeals Affordable Care Act tax on wealthy

(Carolyn Kaster / AP)

The plan guts the Affordable Care Act's 3.8 percent tax on investment income, according to a summary obtained by CNN's Jim Acosta. This is one of the sources of revenue for the health care law, which the GOP is still trying to repeal after its first effort failed last month.

What it means: The move suggests that the Trump administration is looking for other vehicles to knock out some of the taxes in the Affordable Care Act and isn't counting on the repeal effort, even as House Republicans try to revive it.


Dems launch ads on GOP health plan's exemption for Congress

(David Zalubowski / AP)

The DCCC capitalized overnight on an unpopular provision of a new GOP health care amendment, launching ads in 30 Republican districts accusing members of exempting themselves from new waivers that could be added to their health care plan.

The waivers allow states, under limited circumstances, to opt out of the Affordable Care Act's essential health benefits and ban on charging sick people higher premiums, but doesn't apply to members of Congress as originally written. It's currently being rewritten to subject members of Congress to the same rules as everyone else.

The five-figure digital ad buy is in Republican districts being targeted by Democrats, including those of the amendment's author, Rep. Tom MacArthur, and many members who announced their opposition to the original bill.


GOP still optimistic about health care revival

(Evan Vucci / AP)

GOP House members came out of a conference meeting Wednesday morning still optimistic about a health care vote next week, provided the deal-making amendment gets fixed to subject Congress to the same Affordable Care Act regulation waivers as everyone else. Language to fix the issue is being written.

  • What to watch: Moderates, especially those who were a no-vote earlier. Rep. Barbara Comstock, who had previously announced her opposition, was very tight-lipped as she left conference. It's still unclear whether there are still enough moderate holdouts to block the bill.
  • The optimists: Rep. Mark Walker, chairman of the Republican Study Committee, told reporters he thinks the amendment written by Rep. Tom MacArthur could get enough members onboard — particularly moderates, especially after Energy and Commerce Committee chairman Greg Walden spoke in favor.
  • The quote: Rep. Dave Brat, a well-known member of the Freedom Caucus who said last night he is now a yes vote, told reporters the Congressional exemption piece of the amendment is "fixed, guaranteed... Everyone in the room was pretty good. The overall tone was up."


A key part of the House GOP health care compromise

AP file photo

An amendment written by Rep. Tom MacArthur, the basis of a health care deal among House Republicans, allows states to get waivers from the Affordable Care Act's essential health benefit requirements as well as waivers to vary premiums based on health status in limited circumstances.

Both waivers have conditions. Read on for the details.

A waiver from the essential health benefits would be allowed only if a state's plan does one of five things:

    1. Reduces premiums
    2. Increases enrollment
    3. Stabilizes the market
    4. Stabilizes premiums for people with pre-existing conditions
    5. Increases choice of plans
For a waiver on the ban on raising premiums for those with pre-existing conditions, the state must have a high-risk pool.
Other parts of the bill:
  • If a person has stayed insured, they won't see premium increases. The only people with pre-existing conditions who might have to pay higher premiums would be new enrollees in states that get waivers. For those people, the penalty included in the original House health care bill for not having continuous coverage could also be waived.
  • The bill explicitly says states can't vary premiums based on gender.
  • It also says states can't limit access to coverage for people with pre-existing conditions.

GOP health care plan has momentum

Dave Brat and other Freedom Caucus members. Evan Vucci / AP

Several members of the House Freedom Caucus have flipped their votes to yes on a modified health care bill that could potentially come up for a vote next week.

Rep. Dave Brat told Axios the plan "looks good, we like it," and the Washington Post's Robert Costa reports that Freedom Caucus chairman Mark Meadows is on board, as are influential members Jim Jordan and Raul Labrador.

The change: The MacArthur Amendment would allow states to waive a set of "essential health benefits" and a ban on charging sick people higher premiums in limited circumstances and if the state has established a high-risk pool.

Growing optimism: Majority Whip Steve Scalise told Axios, "it's been very positive so far from most members" and Rep. Gary Palmer said of the 216 vote threshold to pass the bill, "I think we're really close, if not there."

Moderates are wary: Rep. Mike Coffman said, "For those of us who were supportive of the last version, we have to pause."


Democrats softening tone on insurer subsidy demands

(J. Scott Applewhite / AP)

Senate Minority Leader Chuck Schumer said Affordable Care Act insurer subsidies are "one of the things, there's a whole list" Democrats want to see included — or not included — in a spending bill deal, due Friday. "Our number goal is no poison pills, we haven't finished negotiating that yet," he said.

Between the lines: This does not sound like a government shutdown threat, which is what Democratic aides were channeling over the last couple weeks.

What to watch: Does any other Democratic leader publicly threaten a shutdown if the insurer payments aren't in the bill?


Sessions hints DOJ will keep fighting Obamacare subsidy case

(Alex Brandon / AP)

Attorney General Jeff Sessions suggested the administration will keep appealing the House lawsuit on the legality of Obamacare insurer subsides in an interview on Fox News on Wednesday.

When asked by an interviewer whether he would "continue to allow the legal process to continue for another judge to take a look at this case," or whether he'll take a "step back from it," Sessions chose the former. "The legal process will continue," he said, indicating the administration will continue to challenge a district court ruling saying the payments are illegal.

Why this matters: The subsidies have become a huge issue as insurers make decisions about the 2018 enrollment period. This doesn't give them much new certainty about what will happen long-term, but it seems to suggest the payments will at least continue while the appeal plays out.


Recess makes Freedom Caucus winners on Trumpcare

David Zalubowski / AP

Moderate Republican House members have had a much tougher recess than conservatives when it comes to Trumpcare. Members from purple districts have had to weather angry liberals and disappointed conservatives, while conservatives have largely emerged as heroes.

I went to the town halls of Reps. Mike Coffman, a Colorado moderate who supported the House health care bill, and Ron DeSantis, a Florida member of the Freedom Caucus who opposed it.

  • Coffman was attacked by liberals angry about his support of Trumpcare, while some Republican constituents expressed disappointment with him for supporting a bill they thought would only make Obamacare's problems worse.
  • Meanwhile, DeSantis received much less blowback (although his town hall was folded into a speaker series at a local college) and is regarded by some of his constituents as having saved them from a bad health care bill.

"I think, quite frankly, most voters in this district were happy with how I explained the problems with the bill," DeSantis told me after his event ended. "Most of the Republicans who were here didn't think it was a good bill, and obviously the Democrats don't want to do anything that deals with Obamacare in that way."

Why this matters: With different factions of the GOP pointing fingers at one another, the blame game is only effective if members' constituents are angry with their representative. Right now, it seems like the Freedom Caucus is actually being celebrated for blocking Trumpcare, which was extremely unpopular nationally.

What to watch: Town halls this recess showed that moderates have the most to lose, and they may have made nervous members even more apprehensive of voting for Trumpcare — especially if it moves further to the right. Meanwhile, the Freedom Caucus has likely been emboldened in challenging GOP leadership.

"Are Republican voters going to blame [opponents of the bill] because the bill failed, because they were raising objections, or are they going to blame the people who created the bill?" DeSantis asked. "My sense is they're more frustrated with how the bill was created and what it didn't do."