The crowning irony of the current fiscal mess is that the ostensible target of Republican shut-down-the-government, default-on-the-debt threats, the Affordable Care Act, is going to be implemented on schedule, with initial enrollment in health care exchanges beginning the very day many other operations of the federal government might shut down, October 1. Wonkblog’s Sarah Kliff explains:
While the health-care law is at the center of the government shutdown fight - Republicans want to defund the law, the White House, predictably, does not - the Affordable Care Act could actually function during a stoppage in federal funding remarkably well. The law’s biggest programs, like the new online marketplaces and health insurance subsidies, would by-and-large move forward without much hindrance at all….
This largely has to do with how the big pieces of Obamacare are funded. The law uses mandatory funds for its really big programs. That includes the new online marketplaces, known as exchanges, where uninsured people will be able to shop for coverage. The Medicaid expansion is funded with mandatory funding, as are the billions in federal tax credits to help with purchasing coverage.
Those mandatory funds were appropriated in the Affordable Care Act and, without repealing Obamacare, legislators cannot touch them. Even in the face of a government shutdown, this is the spending that sticks around.
So, Obamacare is largely insulated from yearly budget negotiations. Or, if you want to put it in CRS-speak, the agency believes that Health and Human Services could rely on “sources of funding other than annual discretionary appropriations to support implementation activities, including multiple-year and non-year discretionary funds still available for obligation as well as mandatory funds.”
You know, if Republicans do succeed in shutting down the federal government next week, HHS ought to put up huge banners everywhere that read: “Obamacare: Still Open For Business.” Maybe buy some billboards in some heavily Republican areas of the country. But that wouldn’t be civil, would it?
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