PHOENIX — Gov. Doug Ducey has signed legislation that could leave more than 205,000 Arizonans without continued health-care subsidies.
The new law bars state and local governments from using their resources to “enforce, administer or cooperate with the Affordable Care Act,” prohibits Arizona from setting up its own state-based health-care exchange or marketplace.
For the moment, that changes nothing: Jan Brewer, Ducey’s predecessor, never sought such authority after the federal law was adopted. And nothing in the federal law forces states to have their own exchanges.
In the interim, Arizonans have been purchasing coverage through exchanges set up by the federal government, and about 75 percent are getting some sort of subsidy to underwrite the cost of the premiums.
But all that could change radically when the U.S. Supreme Court rules — potentially within weeks — on whether the wording of the federal law precludes the government from giving subsidies to those who get their care through a federal exchange. If that is the case, the subsidies go away, making the coverage no longer affordable for many.
The change would not affect the poorest Arizonans, who already get free care through the state’s Medicaid program. Instead, it would mean no financial help for the working poor and middle class who have trouble paying for commercially available coverage.
Ducey dismissed questions of what happens then.
“I’m not going to speculate on what the Supreme Court is going to do,” he said. “We’ll have to deal with the ruling of the court when that ruling comes,” he continued. “And I think we’ll be prepared with some good ideas.”
And depending on the ruling, Ducey said, “the state may have to act.”
Does that mean reversing course?
“No, I’m not in favor of a state exchange,” the governor responded.
“I’ve been outspoken on this issue, and what my opinion is of Obamacare, and I’m no fan of it,” he continued. “But let’s see how the court rules and then we will have a plan of action.”
But the governor denied that by signing legislation prohibiting a state-run exchange he has effectively precluded one option.
“Let’s wait and see how the court rules,” Ducey said. “Once the court rules, the state may have to act, or it may not have to act.”
The legal arguments, heard by the high court last month, go to the wording of the law.
It says that subsidies are available “through an exchange established by a state.” But it is silent about help being available for purchases made through exchanges established by the federal government.
But the Internal Revenue Service has concluded anyone who is financially eligible can get subsidies, regardless of where the coverage was purchased. And attorneys for the administration argued to the court that the clear intent of the law was to make such financial help available to all.
