A push by Senate negotiators to strike a deal on extending enhanced ObamaCare subsidies is running into a brick wall as they struggle to clear a key hurdle on abortion.
Members have been engaged in talks for about a month on a potential extension. But the subsidies expired at the end of last year and Congress left town for Christmas and New Year’s without an agreement, chilling any momentum.
The two sides were hoping to unveil draft legislative text earlier this week, but lawmakers are now aiming for an end-of-January accord.
“We’re still in the red zone. We’re still in the red zone, because we just have to solve these little problems,” said Sen. Bernie Moreno (R-Ohio), who has been one of the lead negotiators.
But time is of the essence. Open enrollment in most states and the federal healthcare.gov exchange ends Thursday. Without the subsidies, out-of-pocket premium costs for tens of millions of people have doubled on average.
Lawmakers said they will extend the open enrollment deadline — but that will require finding an agreement that gets significant Republican support.
And Democrats and Republicans have been unable to find common ground on language regarding the Hyde Amendment, which prevents federal funding for abortion.
Abortion has been the thorniest issue throughout the whole process, negotiators said. Sources on both sides of the aisle have admitted that talks have been going in “circles” on Hyde language, leaving them wondering whether a resolution is possible.
Republicans want stronger guarantees that the enhanced subsidies are not being used to pay for insurance that covers abortion.
House and Senate Republicans, as well as dozens of anti-abortion groups that have spent months lobbying Congress and the White House, oppose any revival and extension of the subsidies that doesn’t bar all Affordable Care Act (ACA) insurance plans from covering abortion.
Democrats don’t think there need to be any changes to the current policy.
Since its inception, the ACA has barred federal subsidies from paying for abortions, but left it up to the states to decide if ACA health insurance plans could cover abortion using state or private funds.
Half of states have opted to ban all coverage of abortion on their ObamaCare markets, including some where abortion is legal. On the flip side, 12 states have laws that require all group and individual plans to include abortion coverage.
“There are a number of anti-choice groups who view this as an opportunity to try and further restrict women’s access,” said Sen. Jeanne Shaheen (N.H.), a top Democratic negotiator.
Despite the troubles, lawmakers are pushing forward.
Sen. Susan Collins (R-Maine), another of the lead negotiators, noted that the group met over Zoom twice during the holiday break, with plans to continue talking during the upcoming recess surrounding Martin Luther King Jr. Day.
“Negotiating a bipartisan, bicameral package on an issue this complex is never easy, but I remain optimistic that we can get there. The people in our negotiations are committed to that,” Collins told The Hill.
She said parts of the bill have been drafted, but she wasn’t sure when a full draft would be ready.
“I’m not sure,” she said. “I had hoped we’d have a bill this week.”
Abortion is hardly the only headwind that has helped push the talks off course.
Lawmakers frequently talk about how Capitol Hill operates on clear deadlines, which these negotiations lack after the subsidies expired at the end of December. Multiple sources noted the lack of a backstop is doing lawmakers no favors as they search for a deal.
“Everything around here gets done when there’s a deadline,” said Sen. James Lankford (R-Okla.), a member of GOP leadership.
“Time’s not on our side. Every day, we say, OK, let’s talk about this some more, and then we schedule a half an hour meeting where half the people leave after five minutes,” Moreno said. “It’s hard to get everybody’s attention. … This can’t continue where we just drag it out because eventually you just run out of time.”
Some top Democrats also remain skeptical that a deal will ever happen given the widespread opposition within the GOP to the subsidies themselves — and ObamaCare as a whole.
The tax credits were the main Democratic leverage point during the 43-day government shutdown, with Republicans refusing to negotiate on them in order to end the impasse.
“Republicans don’t actually want to save the ACA,” said Sen. Brian Schatz (D-Hawaii). “The real impediment is they don’t like this and they don’t want to fund it. … They don’t want to extend these subsidies. They hate these subsidies. They’ve always hated the subsidies. They hated them before they were established, once they were established, they’ve been trying to kill them forever.”
“I don’t see how it’s realistic that they would change their mind after a basically decadelong fight against it,” he said.
Senate Democrats seemed to also get a shot in the arm last week as 17 House GOP members voted last week to back a three-year extension of the subsidies, a similar measure to what Senate Minority Leader Chuck Schumer (D-N.Y.) proposed last year.
The Democratic leader on Wednesday once again tried to pass a three-year extension on Wednesday, but was denied unanimous consent by Senate Republicans.
“That is not a fluke — that’s a blaring signal to Republicans that Americans are demanding relief,” Schumer said of the House vote, noting that a majority of those who voted for Trump are supportive of a tax-credit extension.
“But the Republican Senate is blind, is in a bubble, is not even understanding the anguish of America about these increased health care costs,” he continued. “And they sit there and come up with one excuse after the other why they shouldn’t do this. The House, fortunately, listened to the American people and acted, and the Senate should now do the same.”