'No, stop for a second!': Trump budget chief gets in fiery exchange with CNN's Chris Cuomo over critical Obamacare payments

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Office of Management and Budget Director Mick Mulvaney and CNN anchor Chris Cuomo engaged Wednesday in a fiery exchange about the future of a key piece of the Affordable Care Act.

During an interview on "New Day," Mulvaney and Cuomo argued the merits of what are known as cost-sharing reduction payments.

The CSR payments help reimburse insurers for providing plans with low deductibles and low out-of-pocket costs for poorer Americans on the exchanges. Over the past few months, a slew of insurers and state insurance commissions reported that without the payments, premiums on the exchanges would increase substantially in 2018.

The future of the payments are embroiled in a lawsuit and whether to pay them going forward is essentially up to the Trump administration.

Mulvaney said the administration was deciding whether to pay for the CSR payments on a "month-by-month basis."

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When Cuomo asked whether the administration thought it might be hurting people by "holding those payments hostage" - pointing to the comments from insurers about the dangers of cutting them off - Mulvaney argued that the payments made little difference, since the Obamacare exchanges were already in trouble.

"Yes, because I feel like you're dancing around the reality that you need those payments in order to stabilize the markets," Cuomo said. "And if you're holding them hostage, you're essentially putting people at risk."

"Chris, stop for a second," Mulvaney replied. "Stop for a second. These payments have been there for years. The markets are not stable."

Premiums on these exchanges have increased, though some evidence suggests it is due in part to insurers pricing plans too low in the early years of the law's implementation. A study by The Kaiser Family Foundation, a nonpartisan health policy think tank, showed the Obamacare markets have stabilized and would continue to do so in future years.

Cuomo and Mulvaney also argued about the White House's repeated attempts to discredit the Congressional Budget Office's analysis of the various Republican healthcare bills and the reasons Obamacare markets were not stable over the past few years.

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"When has that ever worked in the insurance world?" Cuomo asked when Mulvaney suggest Obamacare prevented the market from bringing down insurance costs. "When have we ever seen that this free enterprise notion makes things cheaper for people when it comes to health insurance? People were crippled by the cost before the ACA. You know that." 

"Yes, I'd love to have a long conversation about what was broken with health insurance before Obamacare, what continues to be broken with insurance on Obamacare," Mulvaney replied.

"Certainly still problems," Cuomo said.

Watch the exchange: