Why ACA stabilization funds were kept out of the omnibus spending bill

The $1.3 trillion omnibus spending bill released on March 21 includes boosts in funding for HHS, the National Institutes of Health and efforts to fight opioid abuse. What was left out were measures aimed at stabilizing the Affordable Care Act (ACA) exchanges with funding for additional reinsurance and restoring the law’s cost-sharing reduction subsidies.

A vote on these measures had been promised by Senate Majority Leader Mitch McConnell, R-Kentucky, late last year. What kept them out of this spending bill—which Congress has to pass by Friday night to avoid another government shutdown—was a debate over abortions.

As the Washington Post explains, Republicans wanted to attach language referred to as the “Hyde amendment,” which prevents federal funding from being used on abortions. It’s been tacked onto appropriations bills for decades, but in this case, it would’ve prevented health plans which choose to cover abortions from getting any federal money. Democrats wanted to use the same policy as the ACA’s premium support subsidies where eligible customers pay an extra fee for plans which include abortion coverage.

Sen. Patty Murray, D-Washington, accused Republicans of rejecting “bipartisan work on healthcare in favor of partisan healthcare politics.” Republicans countered by arguing inclusion of the Hyde amendment was a “reasonable ask,” according to AshLee Strong, spokesman for House Speaker Paul Ryan, R-Wisconsin.

The spending bill may signal future moves by Republicans on changing ACA-related programs. A provision will require the Trump administration to publish information on the number of federal contractors and employees working on ““implementing, administering, enforcing, or otherwise carrying out” the ACA.

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