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A health care conundrum: help churches or hurt Obamacare

There are plenty of elements of the Affordable Care Act that Democratic officials would love to tweak to make the law more effective, but it's not an option --
A health care conundrum: help churches or hurt Obamacare
A health care conundrum: help churches or hurt Obamacare

There are plenty of elements of the Affordable Care Act that Democratic officials would love to tweak to make the law more effective, but it's not an option -- congressional Republicans have refused to consider any and all changes to "Obamacare."

As we discussed a couple of months ago, it's not because GOP officials love the law the way it is; it's because they hope to sabotage the law and ensure its failure. If Democrats identify worthwhile improvements, and those changes aren't made, Republicans are delighted -- it means a less-effective law. If some groups are unnecessarily punished, so be it.

But Ann Kim and Ed Kilgore recently uncovered an interesting twist: "For the first time, a constituency group to whom the GOP normally pays close attention -- religious institutions -- is asking for a legislative 'fix' of the Affordable Care Act to make it work as intended."

When policymakers wrote the Affordable Care Act, they couldn't prepare for every contingency, and in this case, there was an oversight -- small church health plans were not included as part of the eligibility for ACA exchanges. It was the result of a mistake, not malice.

Two Democrats -- Sens. Mark Pryor of Arkansas and Chris Coons of Delaware -- hope to correct that mistake, and expected bipartisan support. After all, who wants to fight to ensure that church health plans are deemed ineligible? It's a no-brainer -- without a technical fix, most employees of the nation's houses of worship will be able to receive subsidies for coverage, but they'll have to choose from options that leave out their own employer's plan.

How much would it cost to make the adjustment? Nothing. All Congress has to do is alter the eligibility language in the law. Plenty of politically conservative religious groups, including the Southern Baptist Convention, support the fix.

It's left Republicans with a choice: help churches or try to further undermine the health care system. Sahil Kapur reported yesterday that GOP officials appear to prefer Door #2.

An effort by Democrats to fix a glitch under Obamacare that harms small churches is widely expected to be blocked by Republicans, in what would be the latest example of GOP efforts to undermine President Obama's signature legislative achievement by refusing to fix technical problems encountered during implementation.

Oh my.


Tim Jost, a professor of health law at Washington and Lee University and expert on the Affordable Care Act, told TPM, "Absent this amendment it would be difficult for some churches to function as they are now."

"We're not expecting it to get a vote -- at least not anytime soon," said Coons spokesman Ian Koski. "The climate is such right now that Republicans would rather repeal the law than fix it. They're more interested in leaving this loophole open as part of their strategy to undermine the Affordable Care Act. They can go out there now and say the Affordable Care Act is bad for churches instead of working with us to fix the problem."Koski also said it's "not a far leap" to conclude that Republicans also oppose the bill because one of its lead sponsor is Pryor, a vulnerable incumbent and prime GOP target for 2014.

So, it looks like congressional Republicans intend to thwart the needs of houses of worship, on purpose, out of partisan spite.