Mr. President, Tell Health​Care​.gov Enrollees about King v. Burwell and the Risks to Their Coverage

Tonight, President Obama will deliver his annual State of the Union address to Congress. He will no doubt boast that his administration has enrolled 6.8 million individuals in ObamaCare plans in the 37 states with federal Exchanges — i.e., through Health​Care​.gov — and a couple million more in the few states that established their own Exchanges. The State of the Union would also be a good time for the president to be honest with those Health​Care​.gov enrollees, especially the roughly 6 million of them who are purchasing coverage with the help of federal subsidies, about the risks to which he has exposed them.


The Patient Protection and Affordable Care Act, which the president himself signed, expressly provides that those subsidies are authorized only “through an Exchange established by the State.” Since majority of American people have never supported ObamaCare, about three quarters of the states now have refused or otherwise failed to establish Exchanges.


If the president were following the law, he would not be issuing subsidies to any Health​Care​.gov enrollees. Indeed, if the president had followed the law — if he had all along admitted he has no authority to subsidize Health​Care​.gov enrollees — then enough of the country would have seen the full cost of ObamaCare coverage that Congress would have reopened and likely repealed the statute by now. It would have happened even before anyone lost their coverage in the “if you like your health plan you can keep it” debacle of late 2013.

Instead, President Obama insisted on violating the express language of his own health care law. The result is that he put millions of Americans in jeopardy of losing their health insurance – again.


On March 4, the Supreme Court will hear a case called King v. Burwell, one of four challenges to those illegal subsidies, and the illegal taxes that those subsidies trigger. The Court will likely issue a ruling by June. The fact that the Supreme Court agreed to consider King at all means that at least four justices believe the Fourth Circuit’s ruling for the government in King merits review.


If the justices agree with two other lowercourts, they will hold that the president is breaking the law and will put an immediate end to those illegal subsidies. Such a ruling would free the plaintiffs and more than 57 million individuals and employers from being illegally subjected to the aforementioned taxes — ObamaCare’s individual and employer mandates.


The people with whom the president most needs to be honest are the millions of Americans who enrolled in Health​Care​.gov. If the Court finds those subsidies are illegal, then enrollees receiving subsidies would see their health insurance bills quadruple (on average). They would be hit with a new tax bill of up to $5,000. Their plans could disappear, and they may not be able to find a replacement. An estimated one million of these folks left jobs with secure coverage because the president promised them secure, affordable coverage through Health​Care​.gov. Only he never had that power, and by pretending he did, Obama has now made coverage less secure for millions.


Instead of warning Americans of these risks of Health​Care​.gov coverage, the president and his administration have been lying to Health​Care​.gov enrollees. As they lost before lower courts and even as the Supreme Court agreed to hear King just days before open enrollment in Health​Care​.gov began, the White House and administration officials have repeated the mantra that “nothing has changed.” Watch HHS Secretary Sylvia Burwell say “nothing has changed” four times in 90 seconds (go to 3:40).


It is not true that nothing has changed, and the administration knows it isn’t true. The administration knows the risks inherent in Health​Care​.gov coverage have increased, because the administration changed the agreements between Health​Care​.gov and participating insurers to insert a clause allowing insurers to back out if the subsidies disappear:

CMS acknowledges that QHPI has developed its products for the FFE based on the assumption that APTCs and CSRs will be available to qualifying Enrollees. In the event that this assumption ceases to be valid during the term of this Agreement, CMS acknowledges that Issuer could have cause to terminate this Agreement subject to applicable state and federal law.

The administration made the change, reports Inside Health Policy, because insurers demanded it and because administration officials themselves “believe the clause is critical.” 


What does this mean? It means the president knows that millions of Health​Care​.gov enrollees are facing serious financial risks, or worse. Yet his administration is actively concealing those risks from enrollees by telling enrollees “nothing has changed.” At the same time the president is protecting insurers from the risks they face by participating in Health​Care​.gov, he is not even informing consumers about the risks Health​Care​.gov coverage poses for them.


The president needs to put an end to the deception, tonight. He needs to warn Health​Care​.gov enrollees about the risks inherent in their coverage, so they have time to prepare. If he tells them tonight, some of those who need insurance the most might be able to find jobs with secure coverage (or other access to coverage) by the time the Court rules. He needs to tell Health​Care​.gov enrollees what his contingency plans are if the Supreme Court rules that he was breaking the law and playing games with their coverage.


He can blame it all on his political opponents. He can claim to be the only honest man in Washington, for all I care. But he needs to level with Health​Care​.gov enrollees tonight about the risks they are facing. To keep pretending “nothing has changed” would be a reckless lie.