King v. Burwell represents the potential unraveling of the Affordable Care Act as we know it. If the Supreme Court rules in favor of the plaintiffs and determines that subsidies on federal exchanges are illegal, many will look to Congress for an alternative to stabilize insurance markets and provide coverage.
AEI experts Joseph Antos, James Capretta, Tom Miller, and Ramesh Ponnuru offer a contingency plan in the event of a plaintiff victory in King v. Burwell:
If the court rules for the plaintiffs in King, Congress should solve the problems created by the ACA by giving states an alternative approach to providing secure and affordable insurance options. That alternative would be free of the mandates and most of the regulation that marks Obamacare and would therefore result in lower premiums. But it would also be likely to yield high coverage levels and offer protection for people with preexisting conditions.
If this model works over time and residents of the states choosing it find it attractive, that success could pave the way for a larger replacement effort of the ACA.
For supporters of the ACA, congressional action along the lines advocated here ought to be more attractive than letting millions of people lose their subsides with no replacement. For conservatives, demonstrating that there are other ways to help people get the coverage they prefer, without following the government-centric model of Obamacare, ought to be more attractive than doing nothing or passing legislation that expands and entrenches the ACA. The broader public, we suspect, will find this prospect more attractive as well.
Read the full report, “A contingency plan for King v. Burwell and related cases.”
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