JEFFERSON CITY, Mo. (AP) - While the U.S. Supreme Court heard arguments on whether premium health care insurance subsidies could be used in states that did not set up their own exchange, one Republican lawmaker told a Missouri Senate panel Wednesday that the state should bar such subsidies on its own.

Congressional action is needed to fully dismantle the Affordable Care Act, but the bill would be a first step, Sen. Bob Onder said. The Lake St. Louis Republican also said President Barack Obama’s administration was acting “lawlessly” in continuing to offer subsidies in states, including Missouri, which are using the federal government’s website.

“Obamacare has been and continues to be a major drag on the economy,” Onder said.

The bill bars insurers in Missouri from accepting subsidies from the federal government, while the Supreme Court is hearing arguments on whether people in every state can get tax subsidies to reduce the cost of health insurance premiums even if their state did not set up an independent health care exchange.

Opponents say that under the language in the federal health overhaul, only people living in states that created their own insurance exchanges qualify for those subsidies. The administration says doing away with the subsidies in roughly three-dozen states would set off a so-called death spiral for the health care law - declining enrollment, a growing proportion of less healthy people and premium increases by insurers.

Representatives from health care insurance companies Aetna and Anthem Blue Cross Blue Shield told those gathered at the Senate hearing they opposed the bill because it could create a situation where there were two sets of laws.

“We just need to let the court decide,” said David Smith, director of governmental affairs for Anthem Blue Cross and Blue Shield in Missouri.

Groups who oppose the bill said it would take away health care from middle-class Missouri residents and make it more difficult or impossible for them to find other coverage.

Advocates said 217,000 Missouri residents purchased health care on the exchange with the help of a federal subsidy in 2015 and 70 percent of those residents, or 152,000, would not be able to afford other coverage, according to a RAND study.

“I don’t know how we could call that freedom, taking away preventive care and life saving health care when they need it,” Missouri Health Care For All director Jen Bersdale said.

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The bill is SB 51.

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Online

Senate: https://www.senate.mo.gov

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Follow Marie French on Twitter at https://twitter.com/m_jfrench.

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