Editorial: Fix Obamacare in Congress, not courts

The Detroit News
Protesters gather across the Chicago River from Trump Tower to rally against the repeal of the Affordable Care Act Friday, March 24, 2017, in Chicago. Earlier, President Donald Trump and GOP leaders yanked their bill to repeal "Obamacare" off the House floor Friday when it became clear it would fail badly.

A recent decision by Texas U.S. District Judge Reed O’Connor declared the Affordable Care Act unconstitutional due to his interpretation of the individual mandate, following the passage of the Tax Cuts and Jobs Act in December 2017. The decision doesn't mark the immediate end of the controversial health care law, but it should light a fire under Congress to address looming challenges. 

The case, Texas v. Azar, was filed by 20 Republican state attorneys general against the federal government, which was backed by 16 states and Washington D. C. who intervened as defendants in the case.

As the GOP plaintiffs rejoice, the defendants have immediately begun to look toward appealing the decision.

The Tax Cuts and Jobs Act gutted the individual mandate — which had forced Americans to buy insurance or pay a penalty — and axed the penalty. O'Connor's decision said that without a penalty, the law no longer meets the constitutional requirements.

The implications of this decision, if it makes its way to the U.S. Supreme Court, are huge.

But this decision is likely to stay mired in the courts for a long time. Not only would the federal appeals court that oversees Texas have to agree with O’Connor, so would Chief Justice John Roberts, who has written two opinions upholding the health care law in the past.

If Obamacare is struck down by the Supreme Court, many federal health programs would go along with it, including Medicaid expansion, the employer mandate, health exchanges, premium subsidies and federal health-care reimbursement rates for hospitals. In Michigan, about 670,000 individuals have received Medicaid coverage through the Healthy Michigan expansion program under Obamacare and championed by Gov. Rick Snyder. 

In addition, the more than 11 million people who have purchased health care through the Affordable Care Act exchanges would need to find a new provider or relinquish their health insurance.

Yet that doesn't mean the current framework is sustainable. With skyrocketing premiums and choices for coverage ever narrowing, Congress needs to get down to business fixing health care.

Conservatives have a plan in their back pocket: the Health Care Choice Proposal. Developed by a coalition of policy experts called the Health Policy Consensus Group, the proposal would allow states to innovate and reverse some of Obamacare's damage.

"We need to be empowering states to have the health care they need," says Marie Fishpaw, director of domestic policy studies at the Heritage Foundation.

The proposal would not cut the trillion dollars in funding that the federal government spends each year on the Affordable Care Act. It would just dispense the money through grants to the states with two rules: States must use the money to make sure those with pre-existing conditions get coverage and to ensure families can get health care subsidies.

According to an analysis by the Center for Health and Economy, health care premiums would fall by as much as 32 percent under the Health Care Choice Proposal.

Republicans failed to pass an Obamacare overhaul during the two years they had control of Congress and the White House. Now with a divided government, partisan standoffs are expected.

We encourage Congress to find compromise solutions that will improve federal health care policy.