The U.S. Supreme Court will hear arguments Wednesday challenging whether the federal government can pay subsidies to people in Ohio and other states that don’t have state-created health insurance marketplaces set up after the Affordable Care Act, President Obama’s landmark health insurance law.
So what could the ruling mean for Ohio?
Ohio is among the 36 states that joined the federal government’s health insurance marketplace called the exchange, rather than setting up its own exchange when the Affordable Care Act passed. Susan Halpern of Columbus is a freelance contracts and a 9 year breast cancer survivor who bought insurance on the federal exchange.
Good thing, too, she says, because she broke her ankle this weekend and will need two surgeries, so she’s dependent on that federal subsidy to keep her health insurance.
The only way I could continue to pay the premium is to drain my retirement savings. With a history of breast cancer, I cannot be uninsured. At age 55, I need to be putting money towards retirement, not taking it out to pay for health insurance.
Halpern’s cause is supported by several liberal leaning groups, including the Center for American Progress. Vice president Michele Jawando says there’s no mistaking what this case really is about.
“This is actually an ideological attack on the Affordable Care Act that is masquerading as a statutory interpretation case. It is not,” Jawando says.
“It is an ideological attack by opponents of Obamacare or the Affordable Care Act who have not been successful to overturn the bill legislatively, they have not been able to activate it legislative, and so they are turning to the Supreme Court almost as a third branch of their conservative ideology.”
On that point, one Ohio conservative agrees. Maurice Thompson is with the Tea Party backed 1851 Center for Constitutional Law, and has long opposed the Affordable Care Act. He says the ACA is a – quote – hot mess, and that opponents have been transparent in their goal in bringing this case to the Supreme Court.
Our plan has always been, let’s reduce some of the regulations that escalate the cost of health insurance and solve the problem holistically, instead of continuing to slap a solution on top of a problem that Congress created itself.
But if the court strikes down the subsidies, as Thompson and the ACA’s opponents want, that could potentially leave nearly 9 million Americans, including almost 235,000 Ohioans, without health insurance.
But Thompson says one thing Ohio could NOT do is set up its own exchange because of the Health Care Freedom Amendment that voters approved in 2011.
Thompson says the amendment bans the state from enforcing the individual mandate with state resources, from fining employers and from paying for an exchange through state fees or taxes.
“People think of an exchange as just a Travelocity or an Expedia but for health care. And that’s originally what it was supposed to be. But an Obamacare exchange requires a state to do a great number of things in order to have the exchange,” Thompson says.
But two Democratic state lawmakers say that amendment is meaningless in the face of federal legislation, and because the Affordable Care Act would still stand even if the subsidies are struck down, Reps. Michael Stinziano of Columbus and Nicky Antonio of Lakewood are ready with a bill that would require the state to create an exchange if necessary.
And though few if any Republicans like the idea of creating a state-run exchange, GOP House Speaker Cliff Rosenberger of Clarksville says he and other lawmakers are considering the options available to Ohio.
“I don’t know what the courts will do, but when they do make the decision, we’ll have to be prepared to hit those head-on and I think we’re going to be in that position,” says Rosenberger.
I’ve asked that we start thinking how we work with the Governor’s administration and the Senate to make sure we’re prepared for that, but we’ll wait to see what happens when it comes down.
The U.S. Supreme Court isn’t expected to issue a ruling in King v. Burwell until June.