A man holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare in Miami, Fla in 2015.
Photo by Joe Raedle/Getty

Trump agrees to let his health care hostage go (for now)

Exactly two weeks ago, Donald Trump publicly acknowledged a not-so-subtle hostage strategy he thought, at the time, would be a good idea. The Republican president said he was prepared to destroy American health care markets by withholding cost-sharing subsidies – unless congressional Democrats took steps to make him happy.

Trump said on Twitter that he didn’t “want people to get hurt,” before suggesting he’d start hurting people.

Yesterday, the White House decided to let the hostage go – at least for now.
White House officials notified lawmakers earlier in the day that President Trump abandoned a threat to end subsidy payments under the Affordable Care Act, a concession to Democrats that is expected to clear the way for a bipartisan budget agreement. Trump had threatened to cut off the subsidies in an attempt to force Democrats to pay for a wall along the U.S. border with Mexico, a fight that became less serious after Republicans withdrew their border wall request this week.

“It is good that once again the president seems to be backing off his threat to hold health care and government funding hostage,” Senate Minority Leader Charles E. Schumer (D-N.Y.) said. “Like the withdrawal of money for the wall, this decision brings us closer to a bipartisan agreement to fund the government and is good news for the American people.”
A White House official told Reuters, “While we agreed to go ahead and make the … payments for now, we haven’t made a final decision about future commitments.”

It’s apparently Team Trump’s way of effectively saying, “Remember, we can re-take this hostage again at some point.”

White House posturing notwithstanding, it’s a major development. Now that the administration is going to make the ACA payments, the threat of a government shutdown is effectively over and private insurers can move forward with some sense of security about the stability of the markets.

There’s also, of course, what we’re learning about the president’s willingness to follow through on his threats – or in Trump’s case, his ****unwillingness to follow through on his threats.

There was, however, one more angle to this that jumped out at me, and it was included in the Wall Street Journal’s report.
House Speaker Paul Ryan had said earlier Wednesday that Republicans wouldn’t include an appropriation for the cost-sharing reduction payments in the spending bill.

“Obviously, CSRs – we’re not doing that. That is not in an appropriation bill. That’s something separate that the administration does,” Mr. Ryan (R., Wis.) told reporters.
I’ll resist the temptation to delve too deeply into the details here, but what the House Speaker is saying is that the cost-sharing reduction payments won’t be part of the new spending bill that keeps the government’s lights on, but it doesn’t matter because it’s money the executive branch spends as part of the implementation of current law.

That’s true, but Paul Ryan and House Republicans recently filed a federal lawsuit insisting the exact opposite. I don’t want to shock anyone, but I’m starting to think the GOP’s litigation was a politically motivated stunt, unrelated to core principles about policy and constitutionality.

Donald Trump, Government Shutdowns, Health Care, Health Care Policy and Paul Ryan

Trump agrees to let his health care hostage go (for now)