"Do the Math" House Reps Urge Towards Creating a State Health Exchange

COLUMBUS—Urging colleagues in the Ohio General Assembly to “Do the Math,” State Representatives Michael Stinziano (D-Columbus) and Nickie Antonio (D-Lakewood) warn of potentially disastrous financial consequences for hundreds of thousands of Ohioans resulting from a United States Supreme Court decision expected in June.

Reps Stinziano, the Ranking Democrat on the House Judiciary Committee and Nickie Antonio, Ranking Democrat on the Health and Aging Committee are sponsoring legislation in the Ohio House in anticipation of a decision by the Supreme Court in King v. Burwell regarding the legality of continuing to pay premium assistance in states like Ohio which do not run a state health insurance exchange.

The Supreme Court will hear oral arguments in Burwell on Wednesday, March 4.

“If you do the math using information provided by the US Department of Health and Human Services, estimates are that Ohioans would lose federal subsidies in the amount of $50 million each month or $600 million a year if the Court rules that residents in states like Ohio where there is no state exchange cannot legally receive federal subsidies,” Stinziano said.

“While we hope the Supreme Court rules that providing assistance to Ohioans is legal, potentially Burwell puts subsidies to Ohioans at risk.  It’s time to consider again whether Ohioans wouldn’t be better served by a state run exchange,” Antonio said.

According to HHS, currently Ohio enrollment is 234,507 with nearly 85% of enrollees qualifying for federal assistance averaging $247 each month.

“With a state run exchange, Ohio could perhaps extend coverage to more pregnant women not currently enrolled in the Federal Exchange. Providing pre-natal care could go along way towards driving down Ohio’s abysmal infant mortality rates,” said Antonio.

“In King v. Burwell, Plaintiffs argue that the Patient Protection and Affordable Care Act only permits premium subsidies in states that have set up exchanges. Regulations issued by the IRS in 2012 authorized the subsidies to be paid to enrollees in both federal and state exchanges. So, far, just 13 states and the District of Columbia have established state exchanges,” Stinziano said.

Federal premium subsidies are available to uninsured individuals with incomes up to 400% of the federal poverty level, which is $47,080 for a family of one and $97,000 for a family of four in 2015. Individuals eligible for these subsidies paid, on average, just $105 a month for coverage purchased through federal health insurance exchanges. Without these subsidies the average monthly premium would have been $374, according to a recently released U.S. Department of Health and Human Services report.

Reps Stinziano and Antonio (D-Lakewood) are introducing legislation to establish an Ohio Health Care Exchange.