A favorite political trick in Washington is the “Friday news dump,” a strategy of releasing bad news or documents on a Friday afternoon to avoid media coverage and public attention.
Democratic leaders are “touting the short-term health care policies enacted in the American Rescue Plan as examples of ‘historic’ expansions to health care access and affordability. That may be true in the short term, but these increases in Affordable Care Act subsidies are slated to expire in two years, shortly after the 2022 election,” Rep. Jared Golden writes. Scott Hales/Shutterstock.com
This Friday, the House will take up and vote on HR 1868. This bill would extend until Dec. 31, 2021, a moratorium on Medicare sequesters stemming from a 2011 sequestration deal Congress enacted to address the national debt. But here’s the news leaders in Congress don’t want you to see: The bill would also prevent a $36 billion cut to Medicare, as well as $345 billion in cuts to farm assistance, student loans and other programs, triggered by the new COVID-19 stimulus, the American Rescue Plan.
The Republican Party triggered similar cuts when they used budget reconciliation to pass their multitrillion-dollar tax cut in 2017. At the time, Democrats hammered Republican members of Congress for risking cuts to the Medicare program, which provides health insurance to seniors. Both parties later agreed to kick the can down the road and exempt the bill from the pay-as-you-go budget rule.
Today, Democratic leaders in Congress have similarly promised to avoid these mandatory cuts, but doing so will require Republican support to overcome a Senate filibuster, giving Republicans potential leverage in negotiations to eliminate a fiscal cliff entirely of Democratic leadership’s own making. Whether the cuts ultimately occur or the Republican Party uses them as an opportunity to extract policy concessions down the road, Friday’s bill serves as a reminder that there are hidden costs to using budget reconciliation to enact the ARP.
Those hidden costs are not limited to the prospect of across-the-board Medicare cuts. As I argued in my statement explaining my vote against the reconciliation package, the cost of not making strategic spending decisions right now could make it harder to advance the big priorities, like fundamental health care reform, that Democrats have been fighting to achieve for years. Indeed, we are already seeing party leaders attempting a sleight of hand, touting the short-term health care policies enacted in the ARP as examples of “historic” expansions to health care access and affordability. That may be true in the short term, but these increases in Affordable Care Act subsidies are slated to expire in two years, shortly after the 2022 election. While these kinds of temporary expansions allow politicians to campaign on lower health care premiums, they aren’t a lasting solution, and their renewal is far from guaranteed.
For example, a recent report touting the ARP health care provisions cites the fact that a 60-year-old earning just over $51,000 will receive thousands of dollars in healthcare subsidies for the next two years. But after the subsidies expire, they will again face high premiums until they become eligible for Medicare. A more lasting alternative for this 60-year-old would be to permanently lower the Medicare eligibility age to 60, as President Biden proposed during his campaign. Such a change would provide 23 million Americans with an immediate reduction in health care expenses without the financial cliff that follows the expiration of the COVID relief subsidies.
The choice to focus on short-term changes like these rather than long-term reforms that would expand access and reduce costs in a durable way is a reflection of the limitations of the budget reconciliation process. Democrats may think it good politics to set up a fight over expiring health care subsidies in 2023, but it will be a proxy fight that brings us no closer to the kinds of meaningful reforms – like lowering the Medicare eligibility age or expanding health care access through Medicaid – that we have been promising our constituents we would deliver on for years.
These significant reforms would require a meaningful investment from the federal government. That kind of responsible governance forces leaders to set priorities in order, a task that requires difficult decisions and trade-offs. With $6 trillion in COVID spending in the past year, and the Biden administration readying a multitrillion-dollar infrastructure package, the hope that Washington will be able to deliver necessary and lasting health care reforms in this Congress has unfortunately grown dimmer.
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