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Michael Petruzzelli

, National Council for Mental Wellbeing

Budget, ACA Subsidies Take Center Stage as Congress Returns from Recess

April 20, 2017 | ACA | Health Insurance Exchanges | Comments
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When Congress returns from recess on Monday, it will have just one week to finalize a budget deal keeping the government open for the remainder of the 2017 fiscal year. President Trump’s budget request for this year calls for cuts of more than $50 billion dollars to pay for an increase in military spending. While these negotiations continue, health insurers are working with the Administration to secure more than $7 billion in cost-sharing subsidies through the Affordable Care Act. It remains to be seen how these decisions will impact major health care reform legislation.


Back in December 2016, Congress passed a continuing budget resolution providing level funding for government programs through April 28, 2017. As that deadline nears, leaders in Congress and the White House remain at a crossroads on how and when to implement key priorities of the Trump Administration. Last month, President Trump released a high-level budget request that calls for a multi-billion-dollar shift in funding from non-defense public programs (i.e. health, education, transportation, etc.) to additional military spending. As appropriators continue deliberations, it is unclear as to how they will incorporate this request for fiscal year 2017.


President Trump said recently that he may use the cost-sharing subsidies for health insurers as a bargaining chip to bring Democrats along in passing health care reform legislation. The subsidies – passed as a part of the Affordable Care Act in 2010 – are payments funneled to health insurers that participate in the exchanges to help pay for enrollees out-of-pocket costs. This year, those payments equal up to $7 billion.

Insurers are speaking up, reminding the President and Congress that providing the subsidies is “critical to the viability and stability of the individual health insurance markets in a significant number of states across the country.” Adding in that while funding is not assured, “carriers will be forced to think twice about participating on the exchanges. Even if they do decide to participate, state regulators have been informed that the uncertainty of this funding could add a 15 percent to 20 percent load to the rates.”


Reports from Capitol Hill indicate that health reform negotiations continue among leaders in Congress. Speaker of the House Paul Ryan (R-WI) said this week that Republicans are “in the midst of negotiating finishing touches, because our members want to make sure that we lower premiums. It’s difficult to do. We’re very close.” The National Council asks its members to continue their outreach and advocacy on this important issue.

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