Crunch Time For Obamacare Subsidies
December is going to be a busy month in the political world. The due date to release the Epstein files falls on the 19th. New official figures -- the first in months -- on the economy (jobs and inflation) will be released two weeks from now. But the biggest story all month is going to be whether Congress is going to extend the Obamacare subsidies or not. Right now, it's not looking especially good, but things can change quickly.
A vote is supposed to be held in the Senate next week on a bill of the Democrats' choosing to extend the subsidies. That was the promise given by Republican Senate Majority Leader John Thune to end the government shutdown. But so far, it's not looking like enough Republicans will get on board with a simple extension (even one with a few GOP priorities included). Democrats are pretty united on the issue, but Republicans are all over the map. And both sides seem pretty pessimistic about some sort of compromise emerging:
"I can't even get to 13 on the back of an envelope. I can't even get 13 people to say they're open to it," Sen. Brian Schatz (D-Hawaii) said, referencing the 13 Republicans who would need to join with Democrats to get around a Senate filibuster and pass a bill.
Senate Majority Leader John Thune (R-South Dakota) told reporters Tuesday that some Republican senators "want to work with [Democrats] in a constructive way on something that could be a bipartisan solution, but that hasn't landed yet."
Those talks appear to have stalled. Asked how close lawmakers are to a bipartisan solution, Sen. Jeanne Shaheen (D-New Hampshire), who has been a part of the discussions, said, "I think we're not."
There are some Republicans -- mostly in the House, mostly from swing districts -- who would be willing to pass a very simple bill. It would likely extend the subsidies for two years, with income caps added as well as minimum monthly premium charges. Democrats have already signalled that these add-ons would be acceptable to them. Even Donald Trump was apparently getting on board with the concept, before a revolt in his own party from the hardliners on abortion forced him to back off (in the end, Trump made no announcement and offered up no plan).
There are other Republicans who are just fine with letting the subsidies expire. They argue that the subsidies were intended to be short-term to help people deal with the COVID-19 pandemic. These Republicans are not concerned that allowing the subsidies to expire -- which will double or even triple the out-of-pocket costs for many of their own constituents -- will cause any sort of political backlash for the GOP.
And then there are other Republicans who want to use the opportunity to make big changes in the whole system. Trump, a while back, made an off-the-cuff suggestion that money should go directly to consumers rather than to the health insurance companies -- so a few Republicans have been working to craft legislation to do that in some way. There are those anti-abortion hardliners as well, who want further restrictions on Obamacare plans. And there are other Republicans who seemingly want to rewrite major parts of the Affordable Care Act, although no actual plans have been proposed yet.
The question is whether the Democrats can work with the faction of Republicans who truly do want the subsidies extended to get something passed. This might actually originate in the House, not the Senate, since some of this GOP subgroup is now pushing to use a discharge petition to force Speaker Mike Johnson to bring a bill to the House floor. If the House passed a simple bill, the pressure would increase dramatically on the Senate to follow suit.
The big wildcard in all of this is Trump. If nothing passes and the premiums skyrocket for tens of millions of people, Democrats are going to use that as a giant political bludgeon in the midterm elections next year. Some Republicans are very worried about this (as they probably should be). Democrats already have the wind at their backs heading into the midterms, and the subsidy issue fits right in with Democrats' plans to center their campaigns on affordability. There are signs that even Trump is worried about how badly Republicans will be hurt by this, so that might be enough motivation for him to offer his support to an extension of the subsidies.
This could be critical, since Trump's approval would be a big green light for Republicans in Congress to vote for a plan. But if Trump sits the whole fight out and doesn't push Republicans to do anything, the entire effort might just fall apart.
The obvious way out of this problem for Republicans is to pass a simple short-term (two years, most likely) extension of the subsidies and then promise to tackle all the harder issues they've come up with to change the healthcare system some time next year. The deal which ended the government shutdown only extended the budget through the end of January, so they could conceivably address it before then. Or they could decide to take more time later in the year, since if a subsidy extension passes they'll have plenty of time to tackle it.
Or Republicans could just torpedo everything and refuse to act. If Trump stays out of the fracas, Republicans in Congress could just do nothing and allow the subsidies to expire, hoping that the issue wouldn't be as big a deal politically as the Democrats think. This is, of course, a big gamble -- one which could really hurt them in the midterms.
December is going to be a busy month, that's for sure. Other political stories will dominate the headlines for a while (the Epstein files, in particular), but the Obamacare subsidy issue will be much more important politically, since whatever happens could go a long way towards defining the entire midterm campaign season, one way or the other.
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant

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