by Rod D. Martin
April 22, 2015

The Affordable Care Act could be in danger if the United States Supreme Court rules this June (King v. Burwell) that the Obama Administration illegally allowed subsidy payments through federal exchanges. As a result, Republicans will have an opportunity to amend the healthcare law.

Economist, former  U.S. Senator and onetime Presidential contender Phil Gramm writes in the Wall Street Journal:

The language of the Affordable Care Act states that subsidies should only be paid through state exchanges. The bill’s authors perhaps believed that pressure from citizens and the health-care providers who would benefit would entice states to set up exchanges. But, faced with mounting technical problems in setting up the exchanges, the Obama administration decided—legally or illegally—to allow subsidies to be paid through a federally run exchange. Therefore, political pressure that might have convinced states to set up exchanges never developed.

With 13 million people receiving subsidies through the federal exchange next year, there will be intense political pressure from healthcare providers and ordinary citizens to setup state-run exchanges.

The president’s most likely response to an adverse court decision would be to refuse to work with Congress to fix ObamaCare. Instead he will likely mount an effort to force the 37 states now using the federal exchange to set up state exchanges to qualify for the subsidies.

It’s hard to imagine Republican governors and legislatures going against the president if Republicans don’t offer a viable alternative. That being the case, Gramm advocates an alternative he dubs, “the freedom option”.

Every American should have the right to decide not to participate in ObamaCare: If you like ObamaCare and its subsidies, you can keep it. If you don’t, you are free to buy the health insurance that fits your needs. 

The freedom option would fulfill the commitment the president made over and over again about ObamaCare: If you like your health insurance you can keep it. If Republicans crafted a simple bill that guarantees the right of individuals and businesses to opt out of ObamaCare, buy the health insurance they choose from any willing seller (with risk pools completely separate from ObamaCare), millions of Americans would rejoice and exercise this freedom.

Indeed. The only reason to oppose such a measure is if you, like many who voted for the Affordable Care Act, realize and support the fact that Obamacare is built on coercion, and many fewer people will use it if they are offered any alternative whatsoever. Among those “many fewer people”: the young and the healthy, who are forced to subsidize other, less healthy people under the ACA.

Republicans should take the message of healthcare freedom to the American people. If anything was wrong with the system before Obamacare, it was too much government involvement, driving up prices for patients, imposing needless costs on doctors, and generally meddling where privacy matters most.

We can do far better. And Republicans should say so.