Home Get Funding Republicans Bet Health-Care Funds Shuffle Will Help Get Spending Bill Passed

Republicans Bet Health-Care Funds Shuffle Will Help Get Spending Bill Passed

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TC Bell sat with his two daughters Dagny, 8 years old, and Emma, 4, at their home in Denver in November. Mr. Bell’s daughters are recipients of the Children’s Health Insurance Program, which provides low-cost coverage to families earning too much to qualify for Medicaid.
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Tatiana Flowers/Associated Press

Republicans are hoping to land support for a short-term spending bill by agreeing to delay some Affordable Care Act taxes and renewing funding for the Children’s Health Insurance Program, a gamble that shows the continuing resonance of health-care issues in the national debate.

House GOP leaders, seeking to soften Democratic opposition to the spending bill, have included six years of renewed funding for CHIP, which Democrats urgently want. At the same time, they have inserted a repeal of ACA taxes on medical devices, generous employer plans, and health insurance, likely to appeal to conservatives.

But some Democrats deride the CHIP funding as a ploy to get votes, suggesting it won’t be enough to win their backing. And it remains unclear whether the bipartisan support for delaying ACA taxes will be enough to budge votes.

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The spending bill, like most other legislation, needs 60 votes in the Senate. The government’s funding expires at 12:01 a.m. Saturday, and House leaders plan to bring the measure to the floor Thursday to keep the government running through Feb. 16, buying them more time to craft a longer-term agreement.

Democrats have been trying to use their leverage on the spending to secure an agreement on immigration, but a deal has proven elusive. GOP leaders need Democratic support not only because of their narrow 51-49 majority in the Senate, but also because House conservatives may balk at the spending bill.

Republicans hope including health-care sweeteners for both sides will build support. Industry groups hoping to get the ACA taxes delayed or repealed are stepping up their efforts to lobby possible holdout votes.

“It’s critical that policy makers provide urgent relief and much-needed certainty by suspending the tax immediately for 2018 and 2019,” said Elena Tompkins, executive director of Stop The HIT, a group focused on getting a delay of a tax on health insurance.

The spending bill as currently written would suspend the insurance tax for one year. It would also halt for two years a medical device tax and a levy on generous employer plans, known as the Cadillac tax. Republicans haven’t designated a way to offset the cost of delaying the taxes.

Long-term-care ​insurance was supposed to help seniors pay for costly nursing homes and personal aides. Now the industry is imploding. What’s ​at stake for ​more than 7 million Americans who own ​the policies? Illustration: Laura Kammermann/The Wall Street Journal

CHIP, which provides health coverage to about nine million low income children, is supported by Republicans and Democrats, but the parties have been at odds over whether its funding must be made up by spending cuts elsewhere.

A recent report from the nonpartisan Congressional Budget Office, however, said renewing CHIP would actually decrease the federal budget by $6 billion through 2027, because the government wouldn’t have to pay as much on Medicaid and other programs if CHIP remains in place.

Republicans are challenging Democrats to support the spending bill now that it includes CHIP funding.

“I hope my colleagues in the Senate, particularly those who have been so outspoken and riotous in their condemnations of Republicans regarding CHIP, will support this legislation,”

Sen. Orrin Hatch

(R., Utah) said Wednesday. “It would be odd to see them vote it down after all the acrimony we’ve endured the past few months.”

Some Democrats, however, said including CHIP isn’t enough to rescue a spending bill they dislike, in part because it failed to address the “dreamers,” illegal immigrants who were brought to the country as children. They noted the spending bill didn’t include many of their other priorities, including funding for community health centers and investments to fight the opioid epidemic.

“It’s a sad state of affairs when America’s vulnerable take a back seat to powerful multinational corporations and wealthy donors,” said

Sen. Ron Wyden

of Oregon, the top Democrat on the Senate Finance Committee. “What it does do is it delays the health insurance tax. You get a sense that the people who got a big chunk of tax relief at the end of last year, they’re going to get even more in the House bill.”

Both Democrats and Republicans have previously supported delays of ACA taxes. But the Cadillac tax is already postponed until 2020, which reduces for some the urgency of a further delay. Critics say the 40% tax on generous employer insurance plans is passed on to workers.

The 2.3% tax on medical devices, which industry groups strongly oppose, took effect this year, as did the insurance tax.

Sens.

Ed Markey

and Elizabeth Warren, both Massachusetts Democrats, introduced legislation this week to permanently repeal the device tax, a sign of some Democrats’ strong support for undoing that tax.

Write to Stephanie Armour at stephanie.armour@wsj.com

Appeared in the January 18, 2018, print edition as ‘Republicans Offer Health-Care Shift.’

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