House Republicans are gearing up to grill Health and Human Services Secretary Sylvia Mathews Burwell this week over how the administration will handle any potential fallout if the Supreme Court strikes down federal subsidies for health insurance coverage in 34 states operating on the federal exchange. Burwell will testify before the House Ways and Means Committee on Wednesday, ahead of the high court’s ruling in the high-stakes case of King v. Burwell, expected later this month.
The plaintiffs in that case contend that the law’s language only provides for subsidies to people in states that created their own exchange. The Obama administration and authors of the law maintain that the law was intended to offer subsidies to all enrollees who are eligible based on their income regardless of which exchange they used.
If the court rules against the administration, an estimated 6.5 million people could lose their subsidized health coverage. If that happens, experts say it could create a ripple effect throughout health insurance markets in federal exchange states. Nearly everyone agrees that such a ruling would be devastating for millions of Americans. However, there is little agreement over what, if anything, to do to stem such fallout if the court rules for the plaintiffs.
Asked why his administration has given little guidance to states on how to prepare for the potential loss of federal insurance subsidies, President Obama on Monday said, “there is no reason why the existing exchanges should be overturned through a court case.”
King v. Burwell “should be an easy case,” Obama said. “Frankly, it probably shouldn’t even have been taken up. And since we’re going to get a ruling pretty quick, I think it’s important for us to go ahead and assume that the Supreme Court is going to do what most legal scholars who’ve looked at this would expect them to do.”
Obama added that Congress could also resolve any problems raised by a court ruling “with a one-sentence provision.”
That kind of response is unlikely to satisfy House Republicans, who are likely to again question Burwell’s previous claims that the administration does not have a “Plan B” in place if the court strikes down federal subsidies for millions of Americans.
Last week, during a Wall Street Journal breakfast, Burwell explained that the administration’s authority is limited. She added that her agency would work with states that are considering creating their own exchanges or using workarounds to avoid losing out on the federal subsidies.
“As always, we will stand ready to work with states, but in terms of administrative authority, we can’t do much,” Burwell said.
Republicans, who have long sought to repeal Obamacare, have criticized the administration for not having a contingency plan in place if the subsidies get struck down.
Health care spending in the U.S. will grow at an average annual rate of 5.5 percent from 2017 through 2026, according to new estimates published in Health Affairs by the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS).
The projections mean that health care spending would rise as a share of the economy from 17.9 percent in 2016 to 19.7 percent in 2026.
Margot Sanger-Katz and Jim Tankersley in The New York Times: “The deal struck by Democrats and Republicans on Monday to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health care-related taxes.”
“Those delays, which enjoy varying degrees of bipartisan support, are not offset by any spending cuts or tax increases, and thus will add to a federal budget deficit that is already projected to increase rapidly as last year’s mammoth new tax law takes effect.”
Congress passed a law in 2015 requiring the IRS to use private debt collection agencies to pursue “inactive tax receivables,” but the financial results are not encouraging so far, according to a new taxpayer advocate report out Wednesday.
In fiscal year 2017, the IRS received $6.7 million from taxpayers whose debts were assigned to private collection agencies, but the agencies were paid $20 million – “three times the amount collected,” the report helpfully points out.
Goldman Sachs economists see the tax bill adding 0.3 percentage points to GDP growth in 2018 and 2019 while JP Morgan forecasts a similar gain of 0.3 percentage points next year and 0.2 percentage points the year after.
Goldman’s analysts add that federal spending, which is likely to grow more quickly next year than it has recently, will bring the total fiscal boost to around 0.6 percentage points for 2018 and 0.4 percentage points in 2019.
Both banks see deficits likely rising above $1 trillion, or about 5 percent of GDP, in 2019.