Editorial Board

Congress Can Easily Keep the Health-Care Market Stable

Just appropriate the money to keep insurers in the market. Simple. Done.

Working fine.

Photographer: Andrew Harrer/Bloomberg

As Congress threatens again to replace the Affordable Care Act, or try to, along comes further evidence of how well the law is working: Overall, insurers on Obamacare’s exchanges are doing well, and almost all of them say they intend to participate next year -- as the Congressional Budget Office has suggested they would.

There’s just one wrinkle. Their participation depends on the federal government continuing to reimburse them for the billions of dollars they spend to keep copayments and deductibles affordable for millions of low-income policyholders.

It sounds like a technicality, and is. But it’s one that has been turned into a dangerous political device. Congress needs to put it aside, by funding the payments in next week’s spending bill.

The trouble began three years ago, when the House of Representatives sued the Obama administration for making the “cost-sharing” payments. In an obvious bid to undermine the individual insurance market and see Obamacare fail, House Republicans argued that the payments had not been properly appropriated by Congress. A district court agreed with their argument, but allowed the payments to continue while the administration appealed.

Donald Trump’s administration has continued to make the payments, but the president is now threatening to stop them -- he says in an attempt to persuade Democrats to help him kill Obamacare. Trump seems not to notice that the public now holds him and the Republican Congress responsible for any problems with Obamacare.

This explains why Speaker Paul Ryan and other House Republicans have said the cost-sharing payments should continue, even as work on an ACA replacement continues. Yet so far, they have left things in Trump’s unpredictable hands.

They need to bring the matter back into their own court, appropriate the necessary money -- $7 billion this year, $10 billion in 2018 -- and take this risk to Americans’ health-care security off the table.

    --Editors: Mary Duenwald, Michael Newman.

    To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net .

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