Thursday morning the U.S. Supreme Court upheld the constitutionality of federal tax subsidies for the federal Affordable Care Act. The 6-3 ruling affects 87,000 Oklahomans who receive the insurance subsidies designed to make access to health care cheaper.
Subsidies were also at risk in 33 other states that didn't established a state-run marketplace. Instead, residents had to purchase their insurance through a federally run program.
Read the Supreme Court's ruling in King v. Burwell
Gov. Mary Fallin said taxpayers are now stuck with a "deeply flawed" law.
"States need flexibility to pursue their own health care solutions tailored to the needs of their constituents; Obamacare does the opposite by pursuing one-size-fits-all policies," Fallin said in a statement. "Successful health care reform would make health care less expensive and would focus on improved health; but Obamacare has led to ballooning insurance premiums shouldered by hardworking families without corresponding improvements in health outcomes."
Fallin said she wants to see Congress overturn the president's signature piece of legislation.
Attorney General Scott Pruitt said he was disappointed the high court ruled on the statute's context, rather than the "plain language of the law."
"The court acknowledged that the challengers’ arguments were strong, but focused instead on the outcome of their opinion," Pruitt said in a statement. "There’s no doubt the rule of law took a hit today, but I won’t be deterred from continuing to fight for the rule of law and our founding principles.”
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That's the same argument U.S. Sen. James Lankford used earlier this week when he predicted the Supreme Court would rule the subsidies unconstitutional. Lankford said Wednesday the ruling sets a difficult precedent for future legal interpretation.
"The court ruled that because the text of the law is ‘inartful’ in other areas, they assumed it was also inartful related to the state exchange. Oklahomans shouldn’t pay the price for regulators’ free interpretation," Lankford said in a statement. "The problems with Obamacare run deeper than just drafting errors."
Lankford told KGOU's Kate Carlton Greer every time he visits with constituents in his home state, someone brings up a new problem with the ACA.
"Whether it's a physician that's going out of business, whether it's a hospital that's struggling, whether it's an individual that has insurance under the Affordable Care Act but their deductible is so high they can't afford to use it," Lankford said.
Nico Gomez, the CEO of the Oklahoma Health Care Authority, told Oklahoma Watch's Brad Gibson even with the ruling, it will be business-as-usual for the OHCA, and they plan to keep focusing on making sure SoonerCare, the state's Medicaid program, is available for children, pregnant women, and disabled individuals.
"I also think it kind of re-energizes our focus on Insure Oklahoma," Gomez said. "Insure Oklahoma has been a state-based solution that we've had since 2004 to help connect employees, employers, small business folks, to health insurance through premium assistance."
Gomez also said the OHCA has a good working relationship with its federal partner, and he doesn't expect federal government to restrict state waivers to the Afforable Care Act.
"Healthcare.gov, for all its early, early struggles, is a functioning exchange that is available for Oklahomans to take advantage of, and purchase health care in the marketplace," Gomez said.
Lt. Gov. Todd Lamb said activism by the "liberal" judiciary reinforces his belief in states' rights and keeping their issues out of the federal court system.
As Oklahoma's second-highest elected official, Lamb oversees the state Senate, whose day-to-day leader called the ruling "unfortunate."
"Yet again, we are forced to comply with a flawed law that has presented challenges from the beginning," Senate President Pro Tem Brian Bingman (R-Sapulpa) said in a statement. "Instead of improving health care across the nation, Obamacare has burdened families with increased insurance costs, restricted the decision-making authority of states, and negatively impacted our economy."
Bingman's Democratic counterpart, Senate Minority Leader Randy Bass, didn't outright praise the ruling, but said the Affordable Care Act is working, even though it's far from perfect.
“We need to work together to make sure more hard working Oklahomans have access to affordable healthcare," the Lawton Democrat said in a statement. "It’s long past time for us to expand healthcare coverage for low-income, hardworking Oklahomans by accepting Federal funds and expanding Medicaid.”
State Rep. Mike Ritze (R-Broken Arrow), who's also a physician and authored a 2010 "opt out" amendment and a House bill that would've nullified the health care overhaul in Oklahoma, said the high court sided with a "socialist" takeover of healthcare and private decisions.
“The best solution to this government-created healthcare crisis is getting government out of healthcare altogether," Ritze said in a statement. "We should be promoting health savings accounts, allowing health insurance companies to sell insurance products across state lines and making existing plans portable – just like with homeowners or automobile insurance – so that when individuals leave a job they can take their healthcare coverage with them."
Think tanks from both sides of the aisle offered their respective takes. The head of the conservative Oklahoma Council of Public Affairs said the ruling makes state exchanges unnecessary, since people can get subsidies on the federal exchange, and makes it clear health care should be the responsibility of the federal government.
"States should continue to decline to participate in and implement state-based exchanges," President Michael Carnuccio said in a statement. "Responsibility to repeal Obamacare and replace it with policies that actually improve health outcomes has been and remains with Congress."
Gene Perry, the policy director of the left-leaning Oklahoma Policy Institute, called on lawmakers to accept federal dollars to expand Medicaid coverage in the state.
"States that have accepted federal dollars to expand Medicaid have seen large gains in the number of adults with health insurance and given more citizens access to lifesaving screenings and treatments, all while saving money in state budgets," Perry said in a statement. "Hospitals in expansion states are treating fewer uninsured patients, and the amount of 'uncompensated care' they are providing is declining steeply."
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