Lawmakers clash with Burwell over ACA contingency plans

GOP lawmakers clashed with U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell when she testified before a House committee Wednesday, reported The Hill.

The Republicans, led by Rep. Paul Ryan (Wis.), wanted Burwell to describe the Obama administration's contingency plans if the U.S. Supreme Court invalidates subsidies for plans sold on Healthcare.gov in the King v. Burwell case.

"The question is what will the administration do: will they stand up with one piece of paper and say 'my way or the highway' or will he work with Congress?" Ryan said.

He was referring to Obama's comment at the G7 Summit Monday that "Congress could fix this whole thing with a one-sentence provision," FierceHealthPayer previously reported.

Burwell pushed back, saying there's not much that can be done right now while everyone awaits the high court ruling, which is expected by the end of the month.

"We'll do everything we can, we're working to make sure we are ready to communicate to the states and do everything we can," she said. 

Burwell added that states could consider establishing their own health insurance exchanges if the subsidies are ruled illegal on Healthcare.gov. Burwell also said HHS could help support states interested in this option. For example, Pennsylvania and Delaware have proposed launching their own state-based exchanges by using parts of Healthcare.gov, including its website and call center. In addition, states could roll out a cloud-based version of Healthcare.gov in a matter of months and at a fraction of the cost of building an exchange from scratch.

The problem with this option, however, is that Republican-led states would have to agree to work with HHS, which many GOP governors don't want to do.

"The critical decisions will sit with the Congress and states and governors to determine if those subsidies are available," Burwell said.

To learn more:
- read The Hill article