Office of Management and Budget Director Mick Mulvaney told attendees of a Bloomberg Government dinner on Tuesday night that a long-term commitment from the Trump administration to continue key health care subsidies for insurers is unlikely, a source with firsthand knowledge of Mulvaney's remarks told Independent Journal Review.
At the event, a Blue Cross Blue Shield employee asked Mulvaney whether the White House has given any thought to what comes next for health care if the Senate fails to pass an Obamacare repeal next week as expected.
“My guess is you probably won't like it that much,” Mulvaney said, adding that the White House has been evaluating options.
“We are looking at the cost-sharing payments on a month-to-month basis. We made them today. We'll make them tomorrow. But I don't think we'll see a long-term commitment from this administration,” Mulvaney explained.
Cost Sharing Reduction, or CSR, subsidies were implemented by the Affordable Care Act (ACA) to help low-income Americans pay for care. The payments, going to insurance companies to offset out-of-pocket cost reductions for households that fall between 100 percent and 250 percent of the federal poverty level, amounted to $7 billion last year.
Republicans have long opposed the program, suing the Obama administration in 2014 in an attempt to prevent CSR payments. House Republicans moved to end CSR subsidies in their health care legislative effort, but support for the bill collapsed in the Senate.
The White House has threatened to cut off the subsidies in the past, giving insurers some anxiety about the future of the program. Ending CSR payments would likely lead to price hikes and market instability.
Blue Cross Blue Shield and other insurers have been outspoken about their desire for more certainty on the issue, with some even pulling out of ACA exchanges in states like Ohio and Kansas as a consequence this spring.
Despite the pushback, Republicans aren't ruling out the possibility.
“I'm not interested in a bailout for insurance companies alone without reforms,” Majority Whip John Cornyn (R-Texas) told HuffPost this week.
For now, President Donald Trump has the ability to end the payments at any time and, in his words, “let Obamacare fail.” Thursday is the deadline for the next monthly CSR payment.
“I mean, at some point, if you really do believe philosophically that [Obamacare] is going to fail, why throw the money out the bag?” Mulvaney told dinner attendees. “Why have it fail in two years as opposed to having it fail in six months?”
Mulvaney emphasized a decision hasn't been made yet, and he said it continues to be a difficult conversation within the White House.
“I wish I could be more optimistic, but it's not a very optimistic time for health care,” Mulvaney said.