Dispute over health payments defused, spending bill on track

WASHINGTON -- The White House and congressional Democrats on Wednesday defused a standoff over payments for the working poor under the health-care law, keeping a massive government spending bill on track just days ahead of a shutdown deadline.

President Donald Trump on Wednesday backed away from a threat to withhold payments to help people with modest incomes with out-of-pocket medical expenses under Democrat Barack Obama's Affordable Care Act.

The dispute with Democrats, especially House Minority Leader Nancy Pelosi, threatened to hold up the $1 trillion-plus spending bill. A temporary funding bill expires Friday at midnight, and GOP leaders readied plans to pass another short-term spending bill to prevent a government shutdown this weekend -- Trump's 100th day in office.

The weeks-long sniping over the health-care issue had snagged the talks, which have progressed for weeks and gained momentum earlier this week after Trump dropped demands for money for building his long-promised border wall.

"Our major concerns in these negotiations have been about funding for the wall and uncertainty about the ... payments crucial to the stability of the marketplaces under the Affordable Care Act," Pelosi said. "We've now made progress on both of these fronts."

Partisan disagreements over the environment, abortion and GOP efforts to reverse Obama-era financial regulations continue to dog the negotiations, but the administration and many congressional Democrats were hopeful of sealing an agreement relatively soon.

The massive spending measure, which would wrap together 11 unfinished spending bills into a single omnibus bill, represents the first bipartisan legislation of Trump's presidency.

Democratic votes are needed to pass the measure over tea-party opposition in the House and to provide enough support to clear a filibuster hurdle in the Senate, which has led negotiators to strip away controversial policy riders and ignore an $18 billion roster of unpopular spending cuts submitted by White House budget director Mick Mulvaney.

The irony is though Republicans have voted several times to gut Obamacare, many are opposed to cutting off the cost-sharing payments, which could cause the Affordable Care Act's insurance marketplaces to collapse abruptly.

At issue is the $175 billion the government is paying to reimburse health insurers over a decade to reduce deductibles and co-payments for lower-income people. In a lawsuit, the House argued that Congress never specifically appropriated that money, and a federal judge agreed that the administration exceeded its constitutional authority by spending it anyway. The Obama administration appealed, but after Trump won the election last year the case was put on hold.

The outlines of a potential agreement remained fuzzy, but congressional aides familiar with the talks said Trump would emerge with border security funding that's unrelated to the wall and a $15 billion down payment for the military on top of $578 billion in already-negotiated Pentagon funding. Democrats won funding for medical research, Pell Grants and foreign aid.

But negotiators rejected Trump's demands for $1 billion to begin construction of his promised wall along the length of the 2,000-mile U.S.-Mexico border, a high-profile loss on the very week Trump's White House sought to rack up accomplishments before his administration hits the 100-day mark on Saturday.

The aides spoke on condition of anonymity to discuss private negotiations.

The White House and House Republican are also hoping to show progress in their troubled effort to repeal and replace Obama's health law. The hard-right House Freedom Caucus endorsed a newly revised GOP health care bill, seeking to put the measure back on track after the group's opposition helped derail it a month ago.

But neither the spending bill nor the health care measure are likely to receive votes prior to the symbolic 100-day mark. Instead, Trump's wins on Capitol Hill have been limited to about a dozen measures repealing 11th hour regulations issued by Obama and the confirmation of Supreme Court Justice Neil Gorsuch.

The spending measure also appeared likely to extend health benefits for more than 22,000 retired miners and widows whose medical coverage is set to expire Sunday. A permanent fix to the long-festering miners' health issue, costing $1.3 billion over 10 years, was a priority for Democrats like Sen. Joe Manchin of West Virginia and Sherrod Brown of Ohio, along with Republicans representing parts of Appalachia, such as Senate Majority Leader Mitch McConnell.

Mulvaney sparred with Pelosi over the phone on Tuesday evening over health care and in a series of public statements on Wednesday. Ultimately, Pelosi turned to White House Chief of Staff Reince Priebus to obtain assurances that the administration would continue to provide the payments.

Pelosi had demanded that the cost-sharing payments be guaranteed through an add-on to the must-pass spending bill. Republicans refused, in part because adding the issue to the spending bill would have simply been too toxic for conservatives already uncomfortable with having to vote for it.