As its fifth anniversary approaches, the President’s health-care law is again being scrutinized by the Supreme Court.  On March 4, the justices heard oral arguments in the case of King v. Burwell.  The lawsuit alleges that the Administration went beyond the law in implementing Obamacare’s subsidies and mandates.

At the heart of the matter is whether the executive branch can ignore a statute passed by Congress and instead enact policies that serve the Administration’s political interests.  In applying subsidies to both state and federal insurance marketplaces, or “exchanges,” the Internal Revenue Service has unilaterally broadened the scope of the health-care law and federal spending, adding billions of dollars to the national debt.  The law as written allows subsidies only for insurance plans through exchanges “established by the State,” not the federal government.   

An Unworkable Law

The legal battle is yet another glaring example of the health-care law’s flawed framework and dysfunctional implementation. Millions of Americans have lost the plans and doctors they liked.  Many now have coverage that does not meet their needs or their budgets.  Some still do not have coverage at all.  According to the independent Congressional Budget Office, 31 million Americans will lack health insurance by 2024 despite the President’s health-care overhaul.

I am optimistic that the Supreme Court will recognize the Obama Administration’s attempt to rewrite an unworkable law and rule against its unconstitutional overreach.  The King v. Burwell decision could present a prime opportunity to create a better way forward. At the same time, Americans currently receiving subsidies should not abruptly lose their coverage. A transition plan would need to be enacted to prevent innocent people from being harmed simply because they relied on the Administration’s unlawful actions. The American people have already suffered enough from the law’s skyrocketing premiums, canceled plans, and website glitches. 

A Patient-Centered Alternative

The federal government should be prepared for immediate action if the Court rules against the Administration. The White House has said it does not have a backup plan, putting the health care of millions of Americans at risk.  If the Supreme Court finds that the Administration has acted illegally, there are several alternative plans that Republicans in the Senate have put forward.

I support a solution proposed by Sens. Lamar Alexander (R-Tenn.), Orrin Hatch (R-Utah), and John Barrasso (R-Wyo.) that would offer a transitional period for Americans who may lose their subsidies because of the court decision.  The plan would also give states the flexibility to create insurance markets that suit the needs of their residents, rather than exchanges hampered by federal mandates and regulations.  Sen. Ben Sasse (R-Neb.) has a similar proposal that would also protect Americans from lost coverage.

The goal of health-care reform should be broadening access, increasing choice, and lowering costs – ambitions that the President’s law has failed to achieve.  We have seen enough damage from this fundamentally flawed legislation.  It is past time for patient-centered, market-driven policies to put health-care decisions back into the hands of Americans – where they belong.