Tags: Radnofsky | health | Republican | ACA

WSJ's Radnofsky on GOP Healthcare Plans

By    |   Tuesday, 10 Mar 2015 08:02 AM

Louise Radnofsky, health policy reporter for The Wall Street Journal, appeared on C-SPAN's Washington Journal March 9 to talk about proposals the Republicans who control Congress might make in the event plaintiffs are successful in the case of King v Burwell that was argued before the Supreme Court last week.

She said that normally rulings take effect within 25 days, which would mean that tax credits could go away very quickly, and the affected states would not have any time to react. However, she pointed out that Justice Samuel Alito had suggested it would be possible to delay the effective date of a ruling by months, which would leave open the opportunity, albeit a difficult one, for the states to set up their own health insurance exchanges and become eligible for the subsidies under the Affordable Care Act (ACA).

Host John McArdle asked how unusual it is to make such an accommodation, and Radnofsky noted that this is unusual and would require other justices to go along with Alito's idea if the Court ruled for the plaintiffs. The number of people affected was 6 million as of January and would climb further during subsequent enrollment periods.

McArdle followed with a more specific question about how the Republicans propose to replace the exchanges in the event plaintiffs win this case. According to Radnofsky, this depends on who one asks from the administration, Congress and the states, all of which share responsibility for the current state of affairs and have been engaging in finger pointing. Asked what Republicans would do, that also depends on who one asks, not just in Congress but also in the states.

From the standpoint of the administration, the word is that there's nothing it can do to mitigate the impact of an adverse decision. She said the supporters of the bill were intent on impressing the Court that the Act never could have intended for the subsidies not to take effect and that the justices themselves would be responsible for the consequences of an adverse ruling.

As for the congressional Republicans, the administration would like to put the onus on them to come up with a quick patch that would enable the ACA to take effect in perpetuity, but no Republican has indicated a willingness to fulfill this expectation. One option would be to allow the tax credits to continue for a short period of time to buy time to devise a so-called "off ramp" for Obamacare. This is supported by Reps. Paul Ryan, R-Wis., Fred Upton, R-Mich., and John Kline, R-Minn., chairmen respectively of the committees on Ways and Means, of Energy and Commerce and of Education and the Workplace, the three committees with jurisdiction over healthcare legislation. They have all said they are willing to have healthcare tax credits in some form.

Another plan being discussed is sponsored by Sens. Orrin Hatch, R-Utah, Lamar Alexander, R-Tenn., and John Barrasso, R-Wyo., the first two being chairmen of the Senate Finance Committee and Health, Education, Labor and Pension committees, respectively, and Barrasso being an orthopedic surgeon who would only support short-term tax credits.

This writer would caution that it is quite unlikely that the Court will overturn the ACA after Chief Justice Roberts went to such lengths to find a rationale to uphold it just two years ago.

(Archived video can be found here.)

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Robert-Feinberg
Louise Radnofsky, health policy reporter for The Wall Street Journal, appeared on C-SPAN's Washington Journal March 9 to talk about proposals the Republicans who control Congress might make in the event plaintiffs are successful in the case of King v Burwell.
Radnofsky, health, Republican, ACA
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2015-02-10
Tuesday, 10 Mar 2015 08:02 AM
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