Paul Ryan Urges State Lawmakers Not to Set Up Obamacare Exchanges if Supreme Court Rules Against Subsidies

Rep. Paul Ryan urged state lawmakers to resist setting up state insurance exchanges if the Supreme Court rules that key parts of the Affordable Care Act can only continue if they do so.

“Oh God, no…The last thing anybody in my opinion would want to do, even if you are not a conservative, is consign your state to this law,” the Wisconsin Republican told state legislators Thursday during a conference call organized by the Foundation for Government Accountability, a conservative think-tank. The foundation provided a recording of the call.

The high court is expected to rule in June in a case that seeks to restrict the 2010 law’s subsidies to help consumers pay for health insurance to those who bought insurance through a state-run exchange—not the federal HealthCare.gov. Top Republicans see the case as their best opportunity to replace the law, though some have cautioned that Republicans could be blamed for widespread disruption if the subsidies, provided in the form of tax credits, abruptly disappear.

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Mr. Ryan, chairman of the House Ways and Means Committee and the GOP vice presidential nominee in 2012, asked the state legislators to hold firm and promised them congressional Republicans would have alternative health-care legislation—with an official cost estimate—introduced by June 20. The bill, he said, would revive lower-cost, limited coverage insurance plans in states that didn't want their own exchanges. Currently, 37 states use HealthCare.gov.

“If people blink and if people say this political pressure is too great, I’m just going to sign up for a state-based exchange and put my constituents in Obamacare, then this opportunity will slip through your fingers,” he said.

Mr. Ryan said he had met earlier Thursday with Michael Carvin, lawyer for the plaintiffs in the Supreme Court case, who was confident the legal challenge could succeed.

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