Congressional Republicans scored a political victory Thursday when a federal judge ruled the Obama administration was improperly funding a portion of the president’s namesake health care law. But what does the ruling mean for the nearly 600,000 Georgians currently enrolled in Obamacare through health insurance exchanges?
Nothing, for now.
But major changes could be possible should the courts ultimately rule in favor of the House GOP, according to several health care and legal experts.
This particular lawsuit focuses on how the government funds a portion of the Affordable Care Act known as “cost-share reductions.” The judge stayed the ruling, giving the Obama administration time to appeal, which means insurance plans aren’t affected for now.
Ultimately, the fate of the cost-share program won’t be known for months — or years — as the case winds its way through the courts. If the case is ultimately appealed to the Supreme Court, a final decision likely won’t come before President Barack Obama leaves office. And from there, which parties control the White House and each chamber of Congress will have a major impact on what stays in place or is legislated.
“It’s going to take quite a number of months before this gets resolved,” said Timothy Jost, a professor emeritus at Washington and Lee University’s law school and an Obamacare expert.
About two-thirds of the 588,000 Georgians enrolled in Obamacare through the exchanges receive the cost-share reductions, according to the consumer health advocacy group Georgians for a Healthy Future.
The program is aimed at helping cover deductibles and out-of-pocket costs for low-income people who don’t qualify for Medicaid but still make within 250 percent of the poverty line.
“The tax credits and the cost-sharing reductions have really been the key to making coverage affordable for this large number of people who have enrolled in Georgia and allowing them to access health care services,” said Cindy Zeldin, the executive director of Georgians for a Healthy Future.
If House Republicans win the case, insurers would still be required to provide those cost-share requirements under the Affordable Care Act.
The difference would be that there’s the potential — depending on who’s controlling Congress and the White House — that the insurers would not be reimbursed by the government in the way they’ve been in recent years. Insurers could then raise their premiums since they have to continue covering the cost-share reductions, Jost said.
“What it would mean for Georgia is the same it would mean across the country,” said Elizabeth Weeks Leonard, a law professor at the University of Georgia. “There is a certain group of people who currently are participating in the exchanges and have health insurance through those plans who would still be receiving the reduced cost sharing, but the health insurance plans themselves would not receive the federal reimbursement for those reductions so they extend them to the beneficiaries of those plans.”
For Republicans, Thursday’s ruling represents a critical victory in their fight against what they see as overreach by the Obama administration, made especially sweeter after back-to-back Affordable Care Act losses in the Supreme Court. U.S. Rep. Tom Graves, R-Ranger, said it also gives the GOP a key chance to advance its own health care alternative.
“If the ruling stands, the administration’s unconstitutional funding of Obamacare subsidies will end, and Republicans will have an opportunity to advance affordable free-market solutions that strengthen the patient doctor relationship, while providing a variety of choices to meet the uniqueness of every family,” Graves said in a statement.
There is another way that the balance of power could be shifted should the GOP’s challenge ultimately be upheld in court. Such a ruling would give more power to Congress’ appropriations committees to determine how to fund health care programs. That, in theory, could give Graves and Democratic U.S. Rep. Sanford Bishop of Albany, both members of the House committee, more sway.
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