One huge, chronic problem with the House Republicans’ scorched-earth war against the Patient Protection and Affordable Care Act (PPACA) is that they’ve never given the implementers the flexibility needed to get any big new program up and running.
If Republicans saw that there was some obvious flaw in the PPACA provisions that apply to the public exchange system or the commercial health insurance market, and Democrats in the Obama administration saw the exact same flaws, usually, all the Obama administrations could do is to try to regulate away the flaws. Or, if that was not possible, to just forge ahead with a stupid law in place and hope for the best.
Now, Republicans and the Obama administration are engaged in a legitimate fight over how much flexibility Congress should give the PPACA risk corridors programs, which was supposed to collect cash from thriving exchange plan issuers and use it to help stabilize struggling issuers in 2014, 2015 and 2016. And, has to date, not collected much cash from thriving exchange plan issuers.
On the one hand: It seems as if Republicans could make a reasonable argument that increasing risk corridors program flexibility will not actually stabilize the exchanges or the individual health insurance market and will be a waste of money.
On the other hand, Medicare programs that Republicans like have had similar types of stabilization programs in place for years, and Republicans aren’t going around rampaging against those programs. Republicans seem only to hate the versions of “insurer bailout” programs linked to Obama, not the versions linked to President Bush. And insurers could make an argument that it’s mean for the government to promise, or appear to promise, access to financial support for a new project, then yank away the financial support.
On the third hand, I think that, purely on the level of how these conflicts look, not on pragmatic or moral principles, the Obama administration wins these arguments by default.
House Republicans have been so petty that they scared the U.S. Department of Health and Human Services (HHS) into hiding the division that runs PPACA commercial health insurance programs, the Center for Consumer Information & Insurance Oversight (CCIIO), inside the Centers for Medicare & Medicaid Services (CMS), rather than operating it as a stand-alone agency that Republican budget cutters could kill.
See also: HHS Overhauls Consumer Office