The Rhode Island House Finance Committee met to discuss Representative Patricia Morgan’s bill to eliminate HealthSourceRI, and turn the operations of our health care exchange over to the federal government. All the sponsors of House Bill 5329 are Republicans, including Morgan, Dan Reilly, Antonio Giarusso, Justin Price, and Michael Chippendale.
Normally a bill like this wouldn’t attract much attention. It would be dismissed as a cynical statement against a successful social welfare program by right-wing ideologues. But Speaker Nicholas Mattiello, a nominal Democrat, has several times suggested that HealthSourceRI is too expensive and that turning the exchange over to the federal government, something that no state has ever done, might be an option.
As Rep. Morgan explained her bill and her reasoning for it, she alluded to the Speaker’s interest, suggesting that the elimination of HealthSource RI might free up money for Mattiello’s pet project of eliminating the state’s social security income tax. Morgan also mentioned that her bill might find the money required to pay for all day kindergarten, a pet project of Senate President Paiva-Weed, perhaps foreshadowing the compromise that will will see both pet projects come to fruition.
As I mentioned, no state with a functioning, successful state-run health care exchange has shut theirs down. So Rhode Island, in choosing such a path, would be charting unknown and uncertain waters. When Rep Deborah Ruggiero asked Morgan, “What is the cost to the state to return [the health exchange] back to the government?” Rep Morgan seemed uncertain, then replied, “Nothing.”
Ruggiero countered that in her discussion with HealthSourceRI director Anya Rader Wallack, the cost to the state to turn over the exchange is actually “somewhere around $10 million.” In addition, said Ruggiero, “we lose control, obviously, because we no longer have the healthcare exchange in our own state,” a point to which Morgan later replied, “Control is overrated.”
Morgan was also unsure of just how many Rhode Islanders benefit from the exchange, claiming that, “on the website it says that 25,000 are actually paying for their insurance through HealthSourceRI,” but when I looked, the number is actually over 30,000.
Right now, the United States Supreme Court is in the middle of deciding King v. Burwell. If the court decides for King, federal subsidies to those states that don’t have their own health insurance exchanges will vanish. According to US News and World Reports, “The likely scenario is a partial or total market “death spiral” like those, respectively, in New York and Kentucky in the 1990s.” Jumping to the federal exchange now seems pretty stupid in light of the uncertainty regarding the Supreme Court decision, but Morgan isn’t concerned.
“In addressing that, I can tell you that the Obama administration is very confident that they will prevail,” said Morgan, “They have four justices already, they only need one more, to win.” That’s pretty weak sauce, since the other side could say exactly the same thing.
Morgan then went the full Scalia when she said, “On the other hand, if King prevails, and the subsidies are only available to the states, I know from reading, and hearing, that the Republicans in Congress are already working on a fix so that people can continue to get health insurance.”
I have to say, when Morgan made this comment, I looked around the room, wondering if anyone else thought her statement was as darkly comic as I thought it was. No one seemed to.
Compare Morgan’s statement with this exchange in the Supreme Court when oral arguments were heard in King v. Burwell:
Justice Scalia: What about – – what about Congress? You really think Congress is just going to sit there while – – while all of these disastrous consequences ensue. I mean, how often have we come out with a decision such as the – – you know, the bankruptcy court decision? Congress adjusts, enacts a statute that – – that takes care of the problem. It happens all the time. Why is that not going to happen here?
General Verrilli: Well, this Congress, Your Honor, I – – I – –
At least people had the decency to laugh out loud at Scalia’s naiveté. Morgan was actually taken seriously.
Meanwhile, House Finance Chair, Raymond Gallison, promises that there will be full hearings along with full fact finding inquiries conducted before any decision is made on the future of HealthSourceRI.