An Off-Ramp From ObamaCare
If the Supreme Court follows the law, there will be an opening for a sane health-care alternative. Here it is.
The following was written by Republicans John Kline, Paul Ryan and Fred Upton, chairmen, respectively, of the House committees on Education and Workforce, Ways and Means, and Energy and Commerce.
On Wednesday the Supreme Court will take on yet another legal challenge to the president’s health-care law, when the justices hear oral arguments in King v. Burwell. If the court rules against the administration, as any fair reading of the law would demand, millions of individuals and families will hit a major roadblock: They’ll be stuck with health insurance designed by Washington, D.C., that they can’t afford. Americans should have an off-ramp from ObamaCare—a legislative alternative that leads them away from an expensive health-care wreck and toward a patient-centered system.
To review: ObamaCare made health insurance even more costly by requiring plans to include Washington-determined benefits and levels of coverage. The only way to get people to buy these plans was to mandate them. And the only way people could afford these plans was through hundreds of billions of dollars of government subsidies.
But the law—as written—offers subsidies only to people who buy plans “through an Exchange established by the State.” In other words, if you bought a plan through the federal exchange—and more than five million people did in 2014—you’re not eligible for the subsidy.
Not one to worry over the large print, the Internal Revenue Service handed out subsidies to people on both the federal and state exchanges. This blatant disregard for the law has put millions on the hook—because if you received a subsidy and lose it because of the administration’s illegal actions, you’ll face big insurance bills you can’t afford.
The Supreme Court should tell the IRS to enforce the law as written—not as the administration wishes it had been written. As Chief Justice John Roberts wrote in 2012, “Members of [the] Court are vested with the authority to interpret the law” but “possess neither the expertise nor the prerogative to make policy judgments.”
But the question is: Then what? What about the people who will lose their subsidies—and possibly their coverage? No family should pay for this administration’s overreach. That is why House Republicans have formed a working group to propose a way out for the affected states if the court rules against the administration.
What we will propose is an off-ramp out of ObamaCare toward patient-centered health care. It has two parts: First, make insurance more affordable by ending Washington mandates and giving choice back to states, individuals and families. And second, support Americans in purchasing the coverage of their choosing.
Here’s how it would work:
First, make coverage more affordable. Any state that uses our off-ramp would be able to opt out of ObamaCare’s insurance mandates. These coverage requirements are driving up costs, so eliminating them would empower individuals and families to choose from a wider range of plans that fit their personal needs and budgets. Our proposal will also allow participating states to opt out of ObamaCare’s burdensome individual and employer mandates, allowing Americans to purchase the coverage they want.
We would also force insurers to compete for your business, rather than force Americans to buy a government-approved health plan under the threat of IRS fines. Let people buy insurance across state lines. Stop frivolous lawsuits by enacting medical-liability reform. Let small businesses band together so they get a fair deal from insurance companies. Our committees and nonpartisan analysts alike estimate that these proposals will cut costs and raise quality across the board.
At the same time, we would set up other safeguards for patients. We would allow parents to keep children on their plan until age 26. We would prohibit insurers from imposing lifetime limits on benefits. We would protect people with existing conditions. And we would guarantee renewability for people already enrolled in a plan.
Second, help people buy coverage. Right now, those who get insurance through their employer get a lot of help from the tax code, while some people who buy insurance on their own, including potentially the millions of Americans the IRS put at risk, get no help at all. So we would offer those in the affected states a tax credit to buy insurance.
The credit would be “advanceable”—that is, you would get it when you needed it; you wouldn’t have to wait for tax season. It also would be “refundable”—that is, you would get the full amount no matter the size of your tax bill. And would adjust the size of the credit for age; the elderly, who face higher coverage costs, would get more support.
This is a common-sense path—but many members of Congress have proposed a lot of good ideas that deserve further consideration. For example, some have suggested giving states more flexibility to design their own solutions. Yet when House and Senate Republicans discuss this issue, we find that there is a great deal of consensus. We all want to take power away from Washington.
So here’s the bottom line: Under ObamaCare, government controls your choices. Under our proposal, you will. You’ll get to pick a plan that works for you. We look forward to building upon these ideas and working with our colleagues in the House and Senate, health-care experts and, most important, the American people, to put high-quality, affordable coverage within closer reach for all. And we’ll do it by putting Americans, not Washington, in the driver’s seat.