Paul Ryan, the man who keeps tossing bull into the ring by saying Republicans will offer an alternative to the ACA if the Supreme Court kills subsidies in states using Healthcare.gov, is now ordering Republican governors in those states not to set up state exchanges if the Supreme Court rules that federal subsidies can't be paid in states that don't maintain exchanges.
Rep. Paul Ryan urged state lawmakers to resist setting up state insurance exchanges if the Supreme Court rules that key parts of the Affordable Care Act can only continue if they do so.
“Oh God, no…The last thing anybody in my opinion would want to do, even if you are not a conservative, is consign your state to this law,” the Wisconsin Republican told state legislators Thursday during a conference call organized by the Foundation for Government Accountability, a conservative think-tank. The foundation provided a recording of the call.
Mr. Ryan, chairman of the House Ways and Means Committee and the GOP vice presidential nominee in 2012, asked the state legislators to hold firm and promised them congressional Republicans would have alternative health-care legislation—with an official cost estimate—introduced by June 20. The bill, he said, would revive lower-cost, limited coverage insurance plans in states that didn't want their own exchanges. Currently, 37 states use HealthCare.gov.
“If people blink and if people say this political pressure is too great, I’m just going to sign up for a state-based exchange and put my constituents in Obamacare, then this opportunity will slip through your fingers,” he said.
Mr. Ryan said he had met earlier Thursday with Michael Carvin, lawyer for the plaintiffs in the Supreme Court case, who was confident the legal challenge would succeed.
The congressman, who represents Wisconsin’s First District, also said he had concluded, after speaking with Mr. Carvin, that Justice Samuel Alito, in particular, was likely to ensure any decision voiding the credits would have a delayed effect. That would buy time for Republicans to try to enact their alternative proposal, Mr. Ryan said.↓ Story continues below ↓
“It’s not going to be as if in a few weeks all these people in our states, my state included, are going to be out of subsidies and have a 256% increase in their premiums, which is the average price increase we’re predicting. There is no reason to quickly dig yourself into a position and take this.”
Mr. Ryan said state lawmakers should brace for a “high octane” wave of criticism for refusing to set up their own exchanges, but that they could persuade people to embrace a specific GOP alternative.
Make no mistake. This is still about pre-existing conditions, just like it always has been. Here's what Ryan has to say about their "opportunity":
“We think things like community rating and other regulations make insurance needlessly expensive for most people and that there are better more targeted ideas out there to help those with pre-existing conditions get affordable care,” he said. “We just want to give people market freedom and personal freedom so that they can buy what they want.”
Those ideas include reviving high-risk pools, which are state-run insurance pools for people turned down by commercial insurance plans, and beefing up protections that let people with insurance switch their plans regardless of their medical history.
In other words, turn the clock back to 2008 all over again. Because liberty!