Waiting For The Last Minute
There's an old saying that "nothing gets done until the last minute," which is particularly apt when talking about Congress legislating. We are not actually at the last minute yet for extending the Obamacare health insurance premium subsidies, but we're getting really close. Congress will return from its Thanksgiving holiday and have a few weeks before its year-end holiday, which gives it a window to act before the January 1st deadline. Whether it will successfully act or not is still (as always) an open question.
To end the government shutdown, the Democrats who crossed the aisle got a verbal agreement from Senate Majority Leader John Thune that he would allow a vote in December on a bill to extend the subsidies. That vote was to be on a bill of the Democrats' choosing, which could become a crucial distinction. Speaker Mike Johnson hasn't agreed to hold any vote on any bill in the House, but if the Senate acts it's hard to see Johnson not at least allowing a vote on whatever bill they pass. So there is a path to success, but one with a very short timeline.
All along, there have been some Republicans in Congress who have realized that allowing the subsidies to end would be a serious political problem for them. So there are likely enough GOP votes to get something passed in both chambers.
Even Donald Trump has now realized that it would be disastrous for Republicans not to act, so he has jumped into the game as well. Trump was reportedly set to unveil some sort of plan yesterday, but pushback from his own side caused him to postpone such an announcement.
Democrats, of course, would prefer a clean bill -- one that merely extends the subsidies. Ideally, they would extend the subsidies permanently, but that's going to be too much to ask for. Instead, a consensus is emerging among both Democrats and Republicans that a two-year extension is what will be in the bill. This would push the issue out beyond the midterm elections, obviously.
Republicans are going to add things to the bill, and the big question is whether they're going to lard it up with poison-pill ideas that Democrats refuse to vote for or not. Two ideas from Republicans seem acceptable in some form, but others are already being rejected by Democrats. The ideas that Democrats could live with are: capping the income level for people who get the subsidies, and forcing everyone on an Obamacare plan to pay at least a minimum amount per month. The income cap would be pretty generous, and the minimum required payment would be very low. The minimum payments are designed to combat fraud, which Republicans have convinced themselves is massive (but which almost certainly isn't as bad as they portray it). But forcing people to pay five bucks a month for health insurance just so they are aware they have been signed up for insurance isn't that onerous, so Democrats will likely allow this wild-goose fraud chase to happen.
Donald Trump has now inserted himself into the negotiations, putting forth a typical Trump idea that is not well-thought-out and isn't going to work. The question is how hard he will push this idea -- will he insist on it or can he be assuaged with adding some form of it to what Democrats and (some) Republicans already largely agree upon? His idea is to create or expand "health savings accounts" and have the money go directly to people rather than insurance companies. There are all sorts of things wrong with this idea (too many to list here), but the main one is that it wouldn't solve the sky-high premium hikes at all.
Trump, as usual, tried to draw a red line when he announced this idea, writing (in all caps):
THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH.
However, rumor has it that the announcement Trump was going to make yesterday merely added some sort of expansion of this program (two forms of these accounts already exist) to a two-year extension of the Obamacare subsidies. It remains to be seen whether Democrats could accept Trump's idea as an add-on to what they want to accomplish. Some Democrats have already flatly rejected Trump's idea as a replacement for extending the Obamacare subsidies, though, because Trump's idea would not solve the problem. This is likely why Trump was rumored to be ready to announce some sort of plan that contained both his new idea and the two-year subsidy expansion.
The troubling thing right now is that Trump reportedly postponed his announcement due to pushback from hardliners in his own party. Some Republicans just want to let the subsidies to expire altogether. Others see the bill as a vehicle for tightening restrictions on abortion -- which is pretty obviously going to be a non-starter for Democrats.
Sooner or later, Trump will either announce his own plan or fade into the background and let congressional Republicans hash their differences out. This is where that verbal agreement with John Thune could come into play. If Republicans add poison pills to the bill (on abortion or on any other tangential issue), then Democrats could just not vote for it, which would kill its chances of passing. Instead, they would demand a vote on their own bill, which would be a clean extension of the subsidies (perhaps with the income cap and minimum monthly payments included, to get enough GOP votes for it to pass). After the Republicans had their fun with a vote on their hardliner bill (which would fail), then the Senate would have to vote on the real bill -- the one with Democratic support.
There's no guarantee that Thune won't go back on his word, however. He could hold a vote on just the GOP bill and tell Democrats: "This is your only chance to extend the subsidies -- take it or leave it." This would likely mean nothing passes, though, which would leave Republicans very vulnerable in the midterms.
All of this has to coalesce in the next few weeks. It will be the big center-ring issue when Congress returns from the Thanksgiving holiday. There are many ways for this effort to fail, and it will be on a very tight timeline.
But there is reason for optimism, since passing a bill to extend the subsidies would actually help both parties out politically. If the premiums don't skyrocket, then Democrats won't be able to hammer Republicans with the issue out on the campaign trail. But Democrats will be able to tell voters: "We fought hard to achieve this -- the government shutdown worked, in the end." It's rare these days for a bill to politically help out both sides in such a fashion. So perhaps it'll be enough for Congress to actually do something next month (at the last minute, of course).
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant

it always seemed like such an odd reason for the shutdown. like someone focus group tested what people most support and arbitrarily selected just that.