Democrats see ObamaCare leverage in spending fights

House Democrats want to use the looming battle over government spending and raising the debt limit as leverage to shore up ObamaCare.

The minority party believes Republicans will need their votes on the critical fiscal issues, and they think they can secure concessions on healthcare.

“We could make some kind of provisions part of our negotiations on spending in September,” Rep. John Yarmuth (D-Ky.), the ranking member of the Budget Committee, told The Hill as Congress was leaving town.

{mosads}He suggested Democrats attach provisions stabilizing the Affordable Care Act (ACA) to must-pass spending legislation.

“I’m sure we’ll discuss that,” he said.

The government would shut down on Oct. 1 without a new spending measure. Treasury Secretary Steven Mnuchin has set a Sept. 29 deadline for raising the nation’s borrowing limit, a date that suggests the two measures could be tied together for simplicity.

Mnuchin also says it should be a “clean” hike, meaning the administration does not support linking spending cuts to the debt limit bill despite demands from Republicans.

This raises the likelihood of Democratic votes being needed to carry the legislation. In the Senate, Democratic votes will also be necessary to prevent or overcome a filibuster.

Rep. Peter Welch (D-Vt.) said he’s also open to the idea of tying ObamaCare fixes to the fiscal bills.

“We’ll make any effort we can,” he said.

Conservatives in the House are unlikely to back a clean debt limit hike and will want to cut government spending, not continue it.

They are also unlikely to agree to the kinds of ObamaCare fixes desired by Democrats.

Still, it’s possible Democrats could find help from a handful of Republicans.  

Rep. Tom Reed (N.Y.), the Republican co-chairman of the bipartisan Problem Solvers Caucus, is weighing “several possible vehicles” to move ObamaCare reforms when Congress returns, according to his office. Reed had voted in favor of repeal earlier in the year, but more recently backed a series of ACA reforms.

“Rep. Reed feels strongly that at this point, all options must be considered in order to make responsible solutions a reality for the American people,” Nora Retana, Reed’s strategic director, said in an email.

The strategy puts moderate Republicans in the awkward position of seeking ways around their leadership to stabilize a law they’ve long promised to repeal.

But it also poses some political drawbacks for the Democrats, who have relished watching GOP leaders flounder in their repeal effort and think the Republicans will bear the blame for any problems dogging ObamaCare while they control both Congress the White House. Indeed, Democratic leaders, eying big gains at the polls in 2018, have discouraged members from offering ACA fixes throughout most of the year.

That strategy is eroding, however, as rank-and-file Democrats — who were facing mounting pressure at home to offer solutions — have started doing just that. The Problem Solvers group, which features 23 Democrats and 20 Republicans, has launched a comprehensive plan, proposing a series of reforms designed largely to stabilize ObamaCare’s insurance markets.

Democratic leaders have stopped short of endorsing that package. But leaving Washington for the long August recess, House Minority Leader Nancy Pelosi (D-Calif.) vowed that Democrats will support at least one element of the plan — the creation of a “stability fund” to help states reduce premium costs for those with pre-existing conditions — if Republicans will come to the table. 

“House Democrats are prepared to support these vital measures and exchange ideas on how we go forward in other respects,” Pelosi wrote in a July 28 letter to Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.). 

Any GOP support for fixing ObamaCare is sure to bring a harsh backlash from conservative lawmakers, activists and President Trump, who continues to needle the Republicans for their failure to send him a repeal bill. Ryan, who had ushered a repeal bill through the House earlier in the year, also has shown no appetite for the approach.

“We were sent to Washington to fulfill the pledges we made to our constituents,” he said in a statement as Congress left for the recess.

Members of the far-right House Freedom Caucus are eying a plan to force a vote on full repeal when Congress returns to Washington.

Democrats say it’s too early to predict how the healthcare debate will evolve in September — events that will likely influence how they use their leverage in the spending debate. Many are hoping that bipartisan talks in the Senate — discussions supported by McConnell — will force Ryan’s hand in the House.

“Paul Ryan’s always been in search of a unicorn,” Yarmuth said of the Speaker’s focus on repeal.

The Democrats had been largely successful in securing their priorities as part of the omnibus package earlier in the year. And absent some bipartisan breakthrough on ObamaCare, they’re keeping open the option of seeking ACA provisions in a spending package next month.

“I don’t think that’s a bad idea at all,” said a Democratic leadership aide.

Ryan’s office did not respond to a request for comment Friday.

In a twist, Freedom Caucus Chairman Mark Meadows (R-N.C.), among the sharpest critics of ObamaCare, is weighing legislation to stabilize it. In talks with Rep. Tom MacArthur (R-N.J.), Meadows is eying a proposal to guarantee the payment of federal payments, known as cost-sharing reductions (CSRs), to insurance companies that reduce out-of-pocket costs for low-income patients — payments Trump has repeatedly threatened to withhold. The package may also empower states to waive certain insurance rules required under ObamaCare — a change championed by conservatives.

Members of the Problem Solvers Caucus, meanwhile, aren’t waiting for House leaders to make a move, and Reed is in talks with Senate lawmakers, who have been more open to the bipartisan approach. 

“While Rep. Reed continues to work closely with Ryan and other GOP leaders, he is also talking with several senators who are equally committed to getting health care done and welcome practical solutions to the impending crisis,” Retana said.

“Meetings are being scheduled now, promising that September will be a very busy month.”

On that, at least, there is no disagreement.

Peter Sullivan contributed to this story.