The King v. Burwell case before the U.S. Supreme Court could present both challenges and opportunities for our states. The Court will decide later this year whether the Internal Revenue Service had the statutory authority to write a rule allowing health insurance subsidies to flow through federally-facilitated exchanges.
Petitioners argue that the law clearly restricts the subsidies to “an Exchange established by the State” under section 1311 of the Patient Protection and Affordable Care Act (ACA) and that administrative agencies like the IRS cannot alter legislation or spend taxpayer dollars without authorization by Congress. Government attorneys argue that “established by the State” is at worst a drafting error and that Congress clearly wanted subsidies to be available in all of the states.
Most of our states did not create a state exchange, but there still has been significant disruption to our health insurance markets. Many of our citizens have had no other option but to purchase the expensive, mandate-heavy, federally-regulated insurance required by the ACA.
As we wrote in our January 29, 2015, letter to House Speaker John Boehner and Senate Majority Leader Mitch McConnell, we are convinced that states could do a much better job of managing programs if we had greater flexibility and control of funds and regulatory authority. Putting states in the driver’s seat would allow us to provide better services at lower costs to our citizens.
We understand that Congress is working on legislative solutions to provide other options to the states should the Court decide the IRS acted illegally in allowing health insurance subsidies in the federal exchanges. We are eager to have other options. We want to make sure people are able to keep their health insurance, but many governors do not want to be forced to create a state exchange or see our citizens lose coverage. We hope that Congress would offer targeted, temporary relief for people to maintain their current coverage while we work together on free-market, consumer-friendly solutions for the future.
We hope legislation will return control over health insurance to the states so we can offer our constituents a greater variety of policies and robust consumer protections without the excessive costs to comply with the ACA’s rules and mandates.
Republican governors have written before and continue to maintain that the “ACA remains seriously flawed both conceptually and technically. It favors dependency over personal responsibility and will ultimately destroy the private insurance market.”
Regardless of the outcome of King v. Burwell, governors need more flexibility to respond to the different needs of their constituents. “One-size-fits-all” approaches to governance are never the best way to deliver positive results. As policy solutions are created by Congress in the aftermath of the Supreme Court ruling on King v. Burwell, we encourage options that would allow the states the opportunity to innovate and offer health insurance that better meets the needs of our citizens.
Mary Fallin is the Governor of Oklahoma and the Chair of the Republican Governors Public Policy Committee.