June 9, 2015
The Prime Perspective
“Later this month, the Supreme Court is expected to issue a decision in King v. Burwell. The plaintiffs in the case are challenging the legality of tax credit subsidies for coverage purchased through federal healthcare exchanges established by the Affordable Care Act. How would a decision in favor of the plaintiffs impact the congressional agenda this year?”
A ruling for the plaintiffs in King v. Burwell would upset the Congressional agenda for the rest of the summer. Republicans would find themselves in the difficult position of having to legislate a fix to a law they despise. The political fallout for the party if they fail to do so could be substantial, but disagreements within the party on a path forward may prove difficult to overcome. While President Obama may have to make some difficult choices to restore the subsidies, he is unlikely to do so at the expense of other, more essential pieces of the law, such as the individual and employer mandates, which are key to the consumer protections enacted by the Affordable Care Act. States may also begin to take action.Three states-Pennsylvania, Arkansas, and Delaware-have already received approval from the administration to move away from their federally facilitated health care exchanges in 2016.
A victory for the plaintiffs in King v. Burwell might add another ingredient to the big stew of time-sensitive legislative items that is starting to cook and may come to a boil in September. Republican leaders will likely turn to reconciliation as the best instrument to channel the anti-ACA sentiments of their members. A reconciliation package, even with its’ procedural constraints, would probably still overstep what President Obama is willing to agree to-setting up high stakes negotiations as part of the FY 2016 end game. If the ACA becomes a bargaining chip, other Democratic priorities, including non-health care items, may have to be sacrificed in order to save it.