WASHINGTON — Over the past year, a number of Republican lawmakers have gravitated to the claim that there is a central flaw in President Barack Obama’s Affordable Care Act. Jumping aboard a lawsuit that has now made its way to the Supreme Court, they argue that a close reading of the bill prohibits the federal government from giving subsidies to those who purchase health insurance on exchanges that are run by the federal government, of which there are 34.
The question is whether this embrace of the lawsuit represents an epiphany or crass political opportunism. Because not long ago, many of these Republicans were publicly assuming the subsidies they now question were available to everyone, regardless of the exchange on which they shopped.
An August 2013 letter to then-Health and Human Service Secretary Kathleen Sebelius shows how Rep. Paul Ryan (R-Wis.) made this exact shift. Back then, Ryan declared these subsidies would cost taxpayers more than $1 trillion — an amount only possible if they were available nationally, not just in the 15 state-run exchanges in place at the time.
This acknowledgment of the Affordable Care Act tax credits for low- and middle-income households in every state contradicts a brief Ryan and 14 other GOP lawmakers filed to the Supreme Court last month. That document states, “The plain text of the ACA reflects a specific choice by Congress to make health insurance premium subsidies available only to those who purchase insurance from ‘an Exchange established by the State.’”
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Subsidized health insurance consumers in the home states of Ryan, Barrasso and Collins would see some of the highest premium hikes in the country if the King lawsuit prevails, according to federal data analyzed by The Huffington Post.
This could be prevented by amending those few words in the Affordable Care Act that created the opening for the legal challenge. Republicans refuse to consider this solution. Ryan and other GOP leaders maintain they instead will address the disruption by devising an alternative set of health care reforms — a task they have failed to complete in the five years since Obamacare became law — sometime in the next five months.
Jason Cherkis contributed reporting.
