WASHINGTON — Shutting down the government won’t shut down the health care law.
In a quirk of the calendar, the start of enrollment for the Affordable Care Act and the first day of a shutdown would fall on the same day, Oct. 1. The good news for President Barack Obama is cutting off funds for non-essential government programs in a shutdown wouldn’t stop funding for implementing his health care law, policy experts said.
“A shutdown per se doesn’t stop the Affordable Care Act,” said Doug Holtz-Eakin, a former director of the Congressional Budget Office who now leads the American Action Forum, a Washington advocacy group opposed to the health law.
The 2010 law relies mostly on mandatory spending, which congressional inaction can’t stop. It’s the budget category used for benefits such as Medicare and Social Security.
If some Republicans succeed in shutting down the government, opponents of the health care law can’t rely on a closure to impede the ability of new insurance exchanges to link with other agencies.
The exchanges must connect to computers at other federal agencies, including the Internal Revenue Service and the Homeland Security Department, in order to determine whether potential customers are eligible for coverage and for subsidies to help pay their premiums. Those connections probably wouldn’t be jeopardized by a shutdown, Holtz-Eakin said.
“None of these agencies will in their entirety shut down, and their computer infrastructure is a pretty essential thing,” he said.
The Oct. 1 kickoff of open enrollment for state and federal exchanges, where Americans can buy subsidized coverage under the act, coincides with the start of the new fiscal year. The government could temporarily shutdown if Congress fails to enact a short-term spending bill.
Affirmed by the U.S. Supreme Court, the health law is expected to provide insurance coverage for about 25 million Americans now lacking it, at a cost of about $1.8 trillion in the next decade. The fight in Washington is driven by Republicans from districts where opposition to Obama is strongest, inflamed by delays with the health law’s implementation and worries that it will hurt care for people who already have insurance.
Last-minute compromises have become standard in a divided Congress where lawmakers willing to work across the aisle are targeted by outside interest groups. The fiscal compromise that raised taxes for upper-income Americans was struck on New Year’s Day.
This time, the stopgap spending legislation “may well go back and forth from the House and Senate several times” before a final vote, Sen. Ted Cruz, a Texas Republican leading the drive to defund Obama’s health law, said Sept. 20.
So far, the new health insurance marketplaces under the Obama law, called exchanges, are supported by unlimited federal grants in 14 states that are running them on their own.
In 36 states where the government is building all or part of the exchanges, the government has found sources of money independent of Congress to do the work. These include $450 million in fees the government anticipates from insurers in 2014.
“Other sources of funding besides annual discretionary appropriations are available in FY 2014 and beyond to support exchange operations,” the Congressional Research Service wrote in July to Sen. Tom Coburn, an Oklahoma Republican who opposes the health law while not supporting shutting down the government over the issue.
