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Congressional Democrats said Thursday they won’t be coerced into negotiating a repeal of the Affordable Care Act by President Donald Trump’s threats to withhold federal payments critical to maintaining the stability of the insurance market. But the president’s comments could have a more immediate effect on Capitol Hill, thrusting the payments to insurers into negotiations over a spending bill needed to keep the government running beyond April 28, when its current funding expires. (Peterson and Hughes, 4/13)

Party leaders want the issue addressed in the current talks on the spending bill to keep the government open. The bill is due at the end of the month. (Taylor, 4/13)

“The President’s comments on stopping the Cost Sharing Reduction payments will increase costs, is a threat to the good health of the American people and a threat to keeping government open,” an aide to House Democratic Leader Nancy Pelosi (Calif.) said in a written statement. Democrats say Pelosi and Senate Democratic Leader Charles Schumer (N.Y.) are in agreement that the payments must be included in the spending bill being negotiated ahead of an April 28 deadline. Democrats want the funds to become mandatory spending, which would provide the certainty insurance companies have requested. (Sullivan, 4/13)

"Given the threat, we'll be pushing for a robust cost-sharing reduction appropriation," a Senate Democratic aide said. The aide declined to say how much funding Democrats would insist upon. Others have estimated that full funding for one year would require between $7 billion and $8 billion. Funding for the program "must be included" as "permanent mandatory spending," a Pelosi aide said. (Haberkorn and Ferris, 4/13)

“This is a very potent threat, because the administration has the authority unilaterally to do this, and this is really a kill switch. This makes the program unprofitable for the majority of health plans operating in it today,” said Dan Mendelson, chief executive of Avalere Health, a consulting firm. “The timing of this threat is really curious, in the sense that now is the time that the plans have to be deciding whether to bid on 2018. If you’re on the bubble and the president is making a threat like this . . . this just puts more uncertainty on the program." (Johnson, 4/13)

The Democratic aides made clear that the payments could become a potential shutdown issue, since Democratic votes will be needed to pass the bill in the Senate, and perhaps in the House. (House, 4/13)

The head of the House Democratic Caucus is accusing President Trump of “political blackmail” for threatening to withhold ObamaCare funds that lower health costs for poor Americans. Rep. Joseph Crowley (D-N.Y.) said the recent suggestion that Trump may halt billions of dollars in insurance subsidies to force Democrats to negotiate a healthcare overhaul “is a blatant attempt to undermine the Affordable Care Act and manufacture a crisis.” (Illis, 4/13)

President Trump escalated fears this week by saying he may not authorize payment of the Affordable Care Act-required subsidies that up to 7 million people use to help pay their health care deductibles and co-payments. Trump said the move should prompt Democrats to negotiate on health care reform. But now, a bipartisan group including high-level former members of Congress and regulators is fighting back. (O'Donnell, Fletcher, Leys and Alltucker, 4/13)