President Obama and Sylvia Burwell
The onus is on a Republican Congress and mostly Republican states to come up with a solution for the millions of people who could lose their health insurance subsidies in a case the Supreme Court hears next week.
King v. Burwell challenges the tax credits people who live in the states using the federal health exchanges receive. If the court strikes down those subsidies, Secretary of Health and Human Services Sylvia Burwell has told Congress that there is
no regulatory fix.
In a letter to members of Congress on Tuesday, HHS Secretary Burwell said there's no available administrative fix if the Supreme Court limits the subsidies.
"We know of now [sic] administrative actions that could, and therefore we have no plans that would, undo the massive damage to our health care system" resulting from a loss in the case, she said.
It says millions of people would lose the ability to buy health insurance, depleting the coverage pool, and leaving a large number of people in the system who have health problems. That, in turn, would raise the cost of insurance to those still in the system and make hospital emergency rooms once again the only resort for million of Americans.
There is a simple legislative fix available to Congress, but that has been
entirely ruled out by Republican leadership. There's a potential state-level fix, if Republican governors and legislatures want to take it—create their own exchanges. That's complicated, though,
structurally and politically, with plenty of Republican governors
expressing no concern that tens, or even hundreds of thousands of people in their individual states could lose their insurance.
The buck can't be passed to President Obama. If the Supreme Court decides to destroy the subsidies on behalf of the Republican Party, it's the GOP that's going to have to figure out how to clean it up or face the consequences.
