The Philadelphia Inquirer - Option Ready After Ruling on Health Care

Op-Ed

By Joe Pitts

Does the law mean what it says? That's the issue at the heart of the latest court challenge to Obamacare.

This morning in Washington, the Supreme Court will hear oral arguments in King v. Burwell. The plaintiffs are challenging the Obama administration's provision of tax subsidies to individuals in states that have not set up a health exchange. Pennsylvania is among the 34 states that declined to create an exchange.

More than five years ago, then-Senate Majority Leader Harry Reid (D., Nev.) rammed the Affordable Care Act through the chamber on Christmas Eve. The process of creating the legislation was secretive and sloppy. That, however, does not give the administration leeway to contradict what was put into the statute.

The law says that tax subsidies to purchase insurance are available to taxpayers who enroll for coverage in "an exchange established by the state." This would prevent anyone in Pennsylvania from receiving tax credits because the commonwealth elected not to set up an exchange. The federal government operates the exchange in our state through the Healthcare.gov website.

So what were the legislators and staff who drafted the bill thinking? Well, they were probably thinking that the federal government could easily get the states to do the difficult work of constructing exchanges and websites - if they were bribed. If states didn't set up an exchange, the thinking went, then their elected officials would have to explain to constituents why they were losing out on benefits.

It's not just a few words that back up the plaintiffs' case. Other parts of the law seem to assume that benefits are only meant for states with exchanges. Also, one of the architects of the law, Massachusetts Institute of Technology professor Jonathan Gruber, explicitly stated that this was a feature of the law, not a flaw. He said in an interview in 2012: "I think what's important to remember politically about this is, if you're a state and you don't set up an exchange, that means your citizens don't get their tax credits." Gruber tried to walk back these words, but only after his statement became a public embarrassment to the government's case.

Those who drafted the law vastly underestimated the level of opposition to Obamacare. They didn't anticipate that many states would not want to be complicit in the federal government's takeover of the health-care industry. States with already tight budgets didn't want the financial burden of creating and running exchanges.

Obamacare would be fundamentally changed if the Supreme Court sides against the administration. For a law that has never enjoyed popular approval, such a ruling would be a big chance to do things over and this time get it right.

If the court rules for the plaintiffs, House Republicans will not simply stand by and watch millions of Americans lose health insurance. We will be ready to act with legislation.

Our plan has two parts:

End the extensive federal mandates created by Obamacare and give choices to states, individuals, and families.

Create a new way to support Americans' purchase of insurance.

First, we have to ensure real choice and competition. Obamacare made an already expensive service even more costly by creating a host of new mandates. Any state that does not want to participate in the Obamacare exchanges should be able to opt out of big-government mandates and create a program that works best for its residents. This would, for example, let states get rid of the burdensome employer and individual mandates.

Our plan would also help drive the cost of insurance down by giving Americans choices that work best for them. We should allow Americans to shop across state lines. We can also lower costs by passing real medical liability reform that puts an end to junk lawsuits in our health-care system. And let small businesses band together to buy insurance, just as big companies do now.

Second, we will help people get the coverage they need. Our plan would change the tax code to help individuals buy insurance, just as the current code helps big companies. Congress can also consider additional ways to help Americans obtain coverage - like empowering states to draw up innovative coverage solutions tailored for their residents.

Should the court rule against President Obama, he will have a choice. He can either work with Congress to improve health care or watch millions of people suffer the consequences of his failure to provide solid health reform.

House Republicans will be ready. Will the president?

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