State GOP Leaders Press Congress to Revamp Health Care Law

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State Republican leaders are ratcheting up the pressure on Congress to overhaul the Affordable Care Act if the Supreme Court this month rules that subsidies on the federal exchange are invalid.

Republicans from 33 states have written to Congress as part of a coordinated message urging federal legislators to develop a plan that would free states from the pressure of setting up their own exchanges to salvage subsidies, according to the Foundation for Government Accountability, a conservative think tank.

The campaign is the latest sign that Republicans see the Supreme Court case as a chance to repeal most of the 2010 health law. It also underscores the tensions states will face if subsidies on the federal exchange are struck down.

The Supreme Court could rule as early as Monday on the case, King v. Burwell, which claims that language in the law doesn’t allow subsidies to go to people in some three dozen states that use the federal exchange, but only to consumers in states that set up their own online marketplaces for buying health insurance.

At risk are subsidies that help nearly 6.4 million consumers pay their premiums.

“We’ve had a very good response,” said Charles Siler, a spokesman for the Foundation for Government Accountability. “The big thing they’re wanting to do is leverage any political opportunity that may come out of King v. Burwell. This is a federally related problem and they expect Congress to deal with it.”

The letters have been sent this month to House Speaker John Boehner (R., Ohio) and Senate Majority Leader Mitch McConnell (R., Ky.) along with state congressional delegations.

Among the letter-writers, state Rep. Hugh Blackwell of North Carolina said in a June 17 letter that “the court’s King v. Burwell decision should be the catalyst for repeal and new legislation that so many of us have hoped for the last five years.”

Fourteen members of the Louisiana legislature sent letter saying their stance against setting up a state-run exchange hasn’t changed. Another letter came from a coalition of 36 lawmakers in Arizona. More than 350 state lawmakers and leaders have signed onto the letters, according to the foundation.

Proponents of the law have encouraged states to follow the lead of Nevada, New Mexico, Oregon and Hawaii, which use the legal framework of the federal exchange, HealthCare.gov, but are considered state exchanges.

The Republicans in the letter-writing campaign make it clear they would push back against any such option, leaving it to Congress instead to develop an alternative. Republicans have been coming together around a congressional GOP option that would preserve subsidies to offset insurance premiums for as long as two years, but would repeal other parts of the law.

President Barack Obama has indicated he wouldn’t sign any Republican legislative option that struck down central tenets of the law.

“Latching onto HealthCare.gov takes air out of the room to reform the law,” said Mr. Siler.

Arkansas, Delaware, Pennsylvania have received preliminary approval from the federal government to use HealthCare.gov to become state-run exchanges. The deadline for states to set up their own exchanges for 2016 has passed, making it unworkable for other states to make the switch for next year unless rules are changed.

Michael Cannon, one of the architects of the Supreme Court lawsuit, said any efforts by the Obama administration to make it easier for states that go that route could face legal challenges.

“If the administration tries to skirt it, we’ll be back in the same place and there will be lawsuits,” said Mr. Cannon, director of health policy studies at the libertarian Cato Institute.

Conservative lawyers echoed that sentiment. “If HHS tries this I promise there are plaintiffs somewhere and a lawsuit will be filed,” said Josh Blackman, associate professor at the South Texas College of Law.

 

By Stephanie Armour at [email protected]

Source: Wall Street Journal Health