The administration broke its protracted silence Tuesday over a Supreme Court case that could undo Obamacare, telling Congress it has no plan to deal with the “massive damage” that would result from a ruling that left millions of Americans with no way to pay for coverage.
After weeks of deflecting questions, Health and Human Services Secretary Sylvia Mathews Burwell told Republicans there’s no administrative tweak they can take to make sure customers on the federal HealthCare.gov exchange could afford plans if the high court rules the government can’t pay subsidies to them.
“We know of no administration actions that could, and therefore we have no plans that would, undo the massive damage to our health care system that would be caused by an adverse decision,” Mrs. Burwell wrote to Senate Finance Chairman Orrin G. Hatch, Utah Republican.
Her letter marks the first time she has addressed the issue directly, though she didn’t say whether she is going to warn customers of the potential legal land mine.
GOP leaders have cheered on the court case, but have also pledged to have plans ready in case the court does strike down subsidies in the lawsuit known as King v. Burwell.
In December, leading Republicans called on the administration to “ensure that these Americans have all available information” when they decide whether to enroll in 2015 coverage through the federal exchange.
On Tuesday, they said the secretary fell short.
“It’s a response, but it’s not an answer,” said Rep. Joseph R. Pitts, Pennsylvania Republican, who plans to grill Mrs. Burwell on the topic when she appears before his Energy and Commerce subcommittee Thursday to discuss the HHS budget.
The Affordable Care Act said the government can only pay subsidies to customers using exchanges “established by the state,” which a federal appeals court ruled means it excludes the 34 states that relied on the federal website instead.
The administration counters that Congress never intended to treat states differently, and that the GOP is creating a mess and then asking the administration to clean it up.
“We are confident that we will prevail, because the text and structure of the Affordable Care Act demonstrates that citizens in every state would be entitled to tax credits, regardless of whether they purchased their insurance on a federal or state marketplace,” Mrs. Burwell said.
The justices are set to hear arguments next week and rule by June.
Subsidies cover an average of 72 percent of the cost of health plans for those that qualify for the assistance, and many would drop their coverage without the payments, throwing the law’s fragile economics into a tailspin.
“By admitting they have no contingency plan to assist the millions that may lose subsidies, the administration confirms how the misguided law is unworkable for the American people,” Mr. Hatch said.
Analysts, though, say the administration may not want to legitimize the challenge or sway the justices’ thinking by admitting they are working on a backup.
The administration insists that Obamacare is working and that GOP-led attempts to dismantle it will undo their gains.
The Gallup polling company said Tuesday the uninsured rate dropped by 3.5 percent nationwide in 2014 — the first year the federal government required most Americans to hold insurance if they can afford it — and that no state reported a significant increase in its uninsured rate.
States that set up their own health exchanges and expanded Medicaid saw greater gains than states that did not, the pollsters found.