RED ALERT: GOP failed to kill the ACA itself, so they're trying to starve it out instead
In a move which should surprise exactly no one, Congressional Republicans are attempting to defund Planned Parenthood AGAIN:
House Republicans are demanding a series of controversial abortion and health care policies in the annual health spending bill, setting up a showdown with Democrats and threatening passage of an omnibus spending package to keep the government open.
Democrats are vowing to block the slew of long-sought conservative priorities. The riders would cut off federal funding to Planned Parenthood, eliminate a federal family planning program and ax the Teen Pregnancy Prevention Program, according to sources on Capitol Hill. Republicans also want to insert a new prohibition on funding research that uses human fetal tissue obtained after an abortion.
The dispute has stalled negotiations on such other health issues as how much to spend on the opioid epidemic and prompted discussions about buying negotiators more time, with short-term government funding set to expire on March 23 and many of Congress’ other spending panels nearly finished with their bills.
Needless to say, this is a complete non-starter with Democrats and other sane people, but here we are.
However, it's the very last paragraph of the Politico article by Jennifer Haberkorn and Sarah Ferris which really caught my eye this afternoon:
Republicans also want to use the funding bill to go after Obamacare. They would prohibit funding for administering or enforcing the health care law, prohibit the administration from collecting a fee from insurance companies to run the insurance exchanges and eliminate more than half a billion dollars in funding for managing the program at the Centers for Medicare and Medicaid Services.
(sigh) I'm not quite sure how "prohibiting funding for administration" differs from "eliminating funding for managing the program", but it amounts to the same thing: They're trying to shut down CMS's ability to actuall run the ACA.
"Collecting a fee from insurance companies to run the insurance exchanges" refers to the very thing I was asking about a few weeks ago:
According to this article from last May, the total budget for operating HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states,was around $2.1 billion in 2016. Donald Trump proposed slashing the budget down by about 20% to $1.7 billion in 2017.
Where does that money come from? Well, HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states, is not funded out of the general federal budget. Instead, it's funded by assessing a 3.5% premium surcharge on policies sold on it.
...In 2017, the average unsubsidized premium for people enrolled via HealthCare.Gov was $476/month, or $5,712 per enrollee per year. 3.5% of that is $200 per year.
According to CMS, the average effectuated enrollment per month across those 39 states was 7,545,188 people for the first half of 2017. That likely dropped a bit more over the second half of the year to around 7.5 million even. That means HC.gov's total 2017 revenue from the premium surcharge should have been around $1.5 billion. I presume the rest of the funding came from the general HHS Dept. budget.
Ironically, my own February post questioned whether HC.gov even needs as much funding as it appears to be receiving, seeing how the 3.5% surcharge has stayed exactly the same even as average premiums have risen dramatically over the past few years...while HC.gov's operating budget should be dropping since it's been running quite smoothly for the past few years. Even the just-released "ACA 2.0" bill proposed by House Democrats a few days ago asks the same question (it includes a provision for a general audit of HC.gov's budget).
However, that's completely different from cutting off funding altogether.
After everything the House and Senate Democrats have gone through to protect the ACA from an onslaught of attacks and sabotage over the past year (the past 8 years, really), I don't think they're gonna take it simply being starved to death lying down.