House Republicans will include a provision that discourages people from buying health care coverage in the Affordable Care Act’s new marketplaces as part of another short-term funding measure to keep the government open until Dec. 15. Ironically, the bill, which would delay the law’s individual health care mandate for one year and also prevent the federal government from contributing to the health insurance plans of members of Congress, undoes two provisions initially crafted by Republicans.
This continuing resolution is the third short-term funding bill considered by the House in just 10 days.
Delaying the individual mandate — and the penalties associated with not purchasing coverage — would lead less people to purchase insurance and increase premiums. The Congressional Budget Office estimates that the change would boost the number of uninsured by 11 million people in 2014 and attract sicker beneficiaries into the law’s exchanges.
The mandate was initially developed by the Heritage Foundation in 1989 and embraced by many Republicans in the 1990s as a conservative concept that forces individuals and families to take responsibility for their own health care expenses. Former GOP presidential candidate Mitt Romney included the provision as a centerpiece of Massachusetts’ health care reform in 2006.
“If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services – even if that means more prudent citizens end up paying the tab,” the Foundation wrote in 1989. “[N]either the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement…Mandate all households to obtain adequate insurance.”
Similarly, requiring lawmakers and some of their aides to drop their existing health care coverage in the tax-subsidized Federal Health Benefits Program (FEHB) and enroll in the insurance exchanges at the core of the health law was initially proposed by Sen. Chuck Grassley (R-IA). Grassley stipulated that Congressional employees “use their existing employer contribution” to buy insurance in the early drafts of his amendment, though the final law did not specifically mention the role of the employer. In August, the Office of Personnel Management (OPM) ruled that the Congress may apply their employer contributions towards their exchange plans and Republicans are now seeking to completely eliminate the federal subsidies for Congressional employees.
Since the law was designed to provide uninsured people with tax credits to help purchase insurance, the change would place a significant financial burden on Congressional staff.
House Republican moderates are telling reporters that they may vote against the measure in the Rules Committee, leaving leadership unable to bring the resolution to the floor. The Senate pledged to strip these provisions and send a clean continuing resolution — though one that funds the government at sequester levels — back to the House.