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Health Care Law Caught in Budget Fight

WebMD News from Kaiser Health News

Sept. 20, 2013 -- With implementation of major provisions of the Affordable Care Act looming, Republicans see this fall's budget showdown as their last chance to slow or stop President Barack Obama's signature legislation from taking effect. Here is a transcription of a discussion between Mary Agnes Carey of Kaiser Health News and Politico Pro's Jennifer Haberkorn.

MARY AGNES CAREY: Welcome to Health on the Hill, I’m Mary Agnes Carey.

A battle is brewing on Capitol Hill over funding the federal government and the Affordable Care Act is front and center in that fight. Let’s get the latest from Jennifer Haberkorn of Politico Pro. Thanks for joining us.

JENNIFER HABERKORN, POLITICO PRO: Thanks for having me.

MARY AGNES CAREY: First, let’s get a little bit of background. How did the ACA get into the middle of a fight over funding for the government?

JENNIFER HABERKORN: The health law seems to just be so controversial that it manages to work its way into negotiations over every major piece of legislation on the Hill lately. In the last year, we’ve seen it part of the fiscal cliff conversations and other funding measures and it’s here again.

I think the biggest factor this time though is that 2014 is so close. Particularly Oct. 1 when open enrollment will start – that’s less than two weeks away, and Republicans feel like this is their last, best effort to try to stop the law in some way.

MARY AGNES CAREY: There is a measure tomorrow to fund the government through I believe December 15th. We call it the “continuing resolution.” How would that impact the 2010 health care law?

JENNIFER HABERKORN: That would completely defund the health law. It would stop funding for the legislation. It’s unclear exactly how much damage it could do, because some of the health law’s funding through different streams of the government. But, it would be damaging. And Senate Democrats have said they will absolutely vote this down.

MARY AGNES CAREY: So it will still probably pass the House, correct?

JENNIFER HABERKORN: Yes.

MARY AGNES CAREY: So,  it’s going to pass the House, go to the Senate. And so in the Senate, the Democrats aren’t on board, then it fails there?

JENNIFER HABERKORN: It will fail there. Senate Majority Leader Harry Reid said today that it is "dead dead." He said the word "dead" twice.

MARY AGNES CAREY: Just to make it clear.

JENNIFER HABERKORN: Exactly. From there it will go back to the House and that’s when it’s going to get really interesting - how strongly House Republicans are going to push for this.

They could get their legislation through the House, but do they really want to try to defund the health law at the risk of shutting down the government and being blamed for that. So that’s when the House will consider how they’re going to respond if they’re going to keep the health law in their negotiations over government funding or they could decide, "Let’s do this clean. Let’s fund the government and move our fight over the health care law to the debt ceiling," which is the next major battle on Capitol Hill.

MARY AGNES CAREY: So, even if it fails to attach to the continuing resolution, as we look at extending the federal debt ceiling, you could see this same debate come back again.

JENNIFER HABERKORN: Absolutely. It probably will look very similar to the debt ceiling debate. It's not very far away. It’s still before 2014. And Republicans will try to make the same argument: This is one of their last, best chances to stop the law before it goes into effect.

MARY AGNES CAREY: When you mention 2014, you're talking specifically about Jan. 1 where the health insurance exchanges and Medicaid expansion in the states that are participating, that’s when those kick in.

JENNIFER HABERKORN:  Exactly. And Republicans feel like once those benefits are in effect, and once consumers are seeing the exchanges and potentially seeing tax subsidies and cost-sharing, that it’s going to be hard to try to repeal those.

MARY AGNES CAREY: As you noted at the beginning of our conversation, the ACA has figured into many policy debates. House Republicans have voted more than 40 times to fund all or part of the law. There was another hearing this morning where Republicans were talking about their concerns about the law’s navigator program. Yesterday, the Obama administration announced a series of steps aimed at preventing fraud as the ACA is implemented.

What do you think is the cumulative impact of this steady stream of criticism of the law?

JENNIFER HABERKORN: So far we've seen some of these navigator groups express concern that their moves are being highly scrutinized by critics of the legislation. And I think we're going to see them be very cautious once the law rolls out -- when they're trying to sign people up.

But also there's a public image to keep in mind, too. If you’re sitting at home, you don’t know very much about the law but you want to find about it, you might be seeing some of this concern over security and personal information, and it might be just another thing that keeps you away from looking into something like this.

MARY AGNES CAREY: Thanks so much, Jennifer Haberkorn of Politico Pro.

Fri, Sep 20 2013

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