A Marketplace Odyssey: Countdown to October 1 (8 Days)

Part of an ACHP blog series tracking health policy updates in anticipation of the start of the Affordable Care Act’s open enrollment on October 1.

8 days until open enrollment:

Oct. 1 now has added significance: insurance exchange preparations share a deadline with the government budget bill.

Rank-and-file GOP members tilted a House vote Friday morning on a continuing resolution (CR) to keep the government operating for three months but strip the Affordable Care Act (ACA) of its funding. When the Senate considers the CR today, it is almost certain to nix the ACA language. The onus will be back on the lower house with just days left to make a call. It is unclear how Republican leadership will steer its divided party, Politico reports, though Sean Sullivan takes a stab at The Fix.

The hard right is listening to its conservative base – and the narrow vision may be at the expense of the party’s future. A majority of Americans oppose the ACA, but a majority also opposes shutting down the government as a solution (see poll numbers here). In April, a Gallup poll showed Americans consider Republicans bad at compromise.

Sophie Novak of the National Journal offered a friendly reminder last week that cancelling funding does not stop the law. Day-to-day activities and services run by federal money would suffer. The ACA’s funding falls under a different category, one that remains untouched by annual appropriations.

Meanwhile, a government shutdown never looks good. Disastrous political consequences are generally in order for whomever gets blamed. And everybody but the Tea Party seems to agree the blame will fall to the right (see Slate; The Atlantic; Karl Rove).

In August, The Washington Post’s Glenn Kessler remembered the 1996 government shutdown in his Fact Checker column:

“Clinton was in deep political trouble when the Republicans took control of Congress at the start of 1995; he was largely considered irrelevant. The government shutdown is what revived his political fortunes, in part because Republicans appeared too eager for a confrontation, while Clinton constantly emphasized his willingness to compromise within reason… The shutdown sped Clinton on the path to reelection.”

(“I wasn't here in 1995. But that was the last century,” Rep. Tim Huelskamp (R-Kan.) said, according to the Los Angeles Times.)

John Hart, communications director for Sen. Tom Coburn (R-Okla.), echoed that logic, telling the National Journal a shutdown would mean “committing ritual suicide on an altar of bad strategy.”

If the GOP is unlikely to reverse ACA implementation entirely, some of the party’s leaders are intentionally making enrollment perplexing for their citizens, The New York Times explains. This summer, Florida rejected federal money for health care navigators and negated state oversight of insurance rates. Now, Gov. Rick Scott is barring insurance counselors from doing outreach on county health property. Georgia, Missouri and Ohio are also adopting legislation to limit the roles and activities of navigators.

-Sophie Schwadron
ACHP Intern