Speaker Paul Ryan is using health care policy as a way to lure two very different groups of lawmakers into supporting a stop-gap spending measure that will prevent a federal government shutdown.

He’s hoping Democrats will support the bill if it includes funding for the Children’s Health Insurance Program, which ran out of funding on Oct. 1 and is currently subsisting on $2.85 billion of emergency spending that Congress appropriated to get it through March.

To woo the most conservative members of his own party into supporting the bill, Ryan has also included a provision to suspend the medical device tax, a part of the Affordable Care Act that has drawn bipartisan criticism, from conservatives as well as Democrats who represent areas where the medical device industry is significant. The tax was suspended for two years as part of a similar budget deal at the end of 2015, meaning that it is once again in effect this year.

Similarly, the bill would further delay implementation of another unpopular ACA provision: the Cadillac tax on high-cost health plans. That ACA tax also garnered bipartisan opposition, including from unions that were opposed to what they viewed as a threat to generous health benefits they had negotiated for their members. The tax currently isn’t supposed to go into effect until 2020.

Finally, the bill includes a one-year suspension of the Health Insurance Tax (HIT), beginning in 2019.

For Democrats, the choice that Ryan presents them is a painful one for two distinct reasons. First, they have hoped to use the shutdown negotiations as a way to resolve the situation of roughly 800,000 “dreamers”: undocumented immigrants who were brought here as children and were protected by President Obama’s Deferred Action on Childhood Arrivals (DACA) executive order. Second, by supporting the bill, Democrats are helping Republicans weaken Obamacare by cutting off its funding support.

“I’m not going to unwind Obamacare as part of continuing to keep the government open for two or three weeks,” Rep. Jackie Speier, D-Calif, told NBC News. Other Democrats are likely to oppose the bill in solidarity with the Dreamers.

Meanwhile, some Republicans have signaled they are not interested in supporting a bill that does not guarantee big hikes in defense spending.

Rep. Mark Meadows, R-N.C., who leads the House Freedom Caucus, a group of conservative House members, said Tuesday night that he expected some Republicans to vote against the bill.

Instant Insights /

GOP offers CHIP funding, health tax reprieves in exchange for spending bill votes

More From HR Executive

Related Stories

Recommended For You