(Bloomberg) — Several senior Republican senators said Sunday that Congress would let federally based public exchanges offer Patient Protection and Affordable Care Act (PPACA) health premium subsidies for a “transitional period” if a Supreme Court ruling blocks the subsidies.
While the transitional premium subsidy program was in effect, Republicans would design an alternative policy for those states that would provide “the freedom and flexibility to create better, more competitive health insurance markets offering more options and different choices,” the senators wrote in a Washington Post op-ed.
Kings vs. Burwell
The Supreme Court will hear arguments Wednesday in King vs. Burwell (Case Number 14-114). a case challengingwhether the federally based exchanges can offer the subsidies. A decision is expected in June.
The case, brought by opponents of the Patient Protection and Affordable Care Act (PPACA), or Obamacare, has the potential to gut the law in much of the country.
PPACA created a system of health insurance premium exchanges and said state-based exchanges could offer the exchanges. PPACA let the U.S. Department of Health and Human Services (HHS) offer premium subsidies in states that don’t set up their own exchanges, but the text of the law does not say anything about the HHS exchanges offering premium subsidies.
Critics of PPACA say the law gives HHS exchanges no ability to offer the subsidies.
PPACA supporters say that Congress clearly meant to let the HHS exchanges offer the premium subsidies and that, even if Congress did not make that intention clear, other language in the law gives the HHS secretary, Sylvia Mathews Burwell, the discretion to interpret ambiguous language.
What if HHS exchange supporters lose?
If the Supreme Court rules against the Obama administration on the PPACA subsidy issue, that outcome would be celebrated by most Republicans. However, the case has presented a policy challenge for congressional Republicans, who will face pressure to preserve insurance coverage in the event that the court eliminates the subsidies.
“First and most important: We would provide financial assistance to help Americans keep the coverage they picked for a transitional period,” Sens. Orrin Hatch of Utah, Lamar Alexander of Tennessee and John Barrasso of Wyoming wrote in their op-ed. “It would be unfair to allow families to lose their coverage, particularly in the middle of the year.”
Hatch chairs the Senate Finance Committee, Alexander chairs the Health, Education, Labor and Pensions Committee, and Barrasso, a board-certified orthopedic surgeon, is the Republicans’ policy committee chairman.