My Monday article outlining how the Trump administration’s budget proposed bailing out Obamacare caught some by surprise, on several levels. First, the proposal to shovel $11.5 billion to insurers via risk corridors touched on an obscure issue barely discussed since the 2016 election, with no proposals pending before Congress. Second, when I asked administration officials on Monday whether the budget included any Obamacare bailouts, even staff at the Office of Management and Budget (OMB) did not know of these provisions’ inclusion.
For several reasons, the proposed bailout appears to trace back to one individual—Andrew Bremberg, head of the White House’s Domestic Policy Council. First, a Washington Post story in October on the Senate proposal to fund cost-sharing reduction payments that the Trump administration cancelled made clear that Bremberg, unlike many of his White House colleagues, supports bailing out Obamacare:
During the negotiations, Democrats had proposed delaying the open enrollment period for [Obamacare] plans, which is set to begin Nov. 1, for a month after the bill’s enactment to ensure that firms could lower their 2018 premium rates to reflect the fact that the government would keep funding the subsidies. White House Domestic Policy Council Director Andrew Bremberg opposed that provision, Schumer said, but he added that Democrats are willing to insert stronger language to guarantee that insurers pass on the payments to their customers. [Emphasis mine.]
The Post article went on: “Many senior White House officials oppose the bill, according to administration officials and Republicans who have been briefed on the matter.” Note the key difference: Whereas other senior White House official opposed the Senate bill—i.e., the entire concept of bailing out Obamacare—Bremberg opposed only one particular provision regarding open enrollment dates, and therefore supported the principle of increasing taxpayer subsidies to insurers.
Indeed, my sources in the administration have for the past year considered Bremberg, along with former Health and Human Services Secretary Tom Price, one of the prime forces advocating for efforts to “stabilize” (i.e., bail out) the Obamacare exchanges. Bremberg argued for keeping the cost-sharing reduction payments, notwithstanding the lack of a valid appropriation for them, and now wants to restore them.
In the most charitable interpretation, Bremberg wanted to avoid undermining the exchanges before a “repeal-and-replace” bill could win support and take effect. In a less charitable interpretation, Bremberg would throw as many corporate welfare dollars at insurers as possible, in the hopes they will lower premiums in a way that benefits Republicans politically.
Another issue traces the budget plan back to Bremberg: Abortion. The budget did not include any Hyde amendment protections to prevent the funds in question from subsidizing abortion coverage. I noted on Monday that that failure “represents at best a massive managerial oversight, and at worst an insult to the pro-life community.”
Before working for the Trump campaign and administration, Bremberg got his start in the 2016 campaign cycle as policy director for the campaign of Wisconsin Gov. Scott Walker. In that role, Bremberg drafted a health care plan for Walker that—just as with Monday’s budget—included not a single pro-life protection to ensure that federal funds not subsidize abortion coverage. At the time it seemed stunning that, even as the release of hidden videos brought attention to Planned Parenthood’s unscrupulous practices, Bremberg did not think to include a single word about pro-life protections in Walker’s health-care plan.
Likewise the exclusion of any pro-life protections associated with an Obamacare bailout. If releasing a health-care plan for a Republican presidential candidate without any pro-life language is a fireable offense—and in my view, it likely warrants that sanction—then doing the same thing a second time in a Republican administration is completely inexcusable. At best it illustrates a stunning lack of competence regarding the details of health policy for someone dubbed “Donald Trump’s details guy.” At worst it demonstrates an arrogance bordering on contempt for the pro-life movement and evangelical Christians who helped get Trump elected in the first place.
The Rob Porter scandal has drawn newfound attention to concerns about staffing and operations within the White House. The Obamacare bailout proposal in the budget, coupled with the lack of pro-life protections regarding same, should only heighten those fears. The latter raises questions not only about the extent to which this administration lacks fidelity to conservative principles, but also lacks policy savvy and sheer political competence.
Mr. Jacobs is founder and CEO of Juniper Research Group, a policy consulting firm. He is on Twitter: @chrisjacobsHC.