(Bloomberg) — 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 that cutting off funds for non-essential government programs in a shutdown wouldn’t stop funding for implementing his health care law, health policy experts say.
“A shutdown per se doesn’t stop the Affordable Care Act,” says 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.
That’s because the ACA relies primarily 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 ACA 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 says.
“None of these agencies will in their entirety shut down, and their computer infrastructure is a pretty essential thing,” he says.
This time, the stopgap spending legislation “may well go back and forth from the House and Senate several times” before a final vote, Senator Ted Cruz, a Texas Republican leading the drive to defund Obama’s health law, said in a Sept. 20 statement.
So far, the new health insurance 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 Senator Tom Coburn, an Oklahoma Republican who opposes the health law while not supporting shutting down the government over the issue.
When the Obama administration faced the risk of Congress shutting down the government, in December 2011, the Department of Health and Human Services said in a memo that it would keep the Affordable Care Act running.
Instead, congressional failure to fund the government would prompt the HHS to halt down programs that rely on “discretionary” spending, money that Congress has to renew every year.
These included the $30 billion National Institutes of Health, the biggest source of money for biomedical research in the world; anti-fraud programs at Medicare; programs for elderly people; Head Start grants for pre-kindergarten education; and grants for groups that care for people with HIV and AIDS.
The NIH wouldn’t make grants and would not admit any new patients to its research hospital in Bethesda, Maryland.
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