Obamacare is one of the most successful pieces of legislation in recent history, and the cornerstone of President Obama’s presidency. Given that, and given their radical hatred for the president, it’s no wonder the Republicans have tried everything possible to destroy the law.
It’s ironic then, that on what might be the eve of their victory, they’re in full damage control mode.
A mistake in the fine print
The current lawsuit against Obamacare, King v. Burwell, hinges on a literal interpretation of the law.
Opponents of the ACA are claiming that the law allows the federal government to subsidize premiums only in those states that have set up their own health insurance market places.
Those states are: Hawaii, Washington, Idaho, California, Colorado, Minnesota, Kentucky, New York, Maryland, Connecticut, Rhode Island, New Hampshire, Vermont, Massachusetts, and Washington D.C. If your state was not on the list, it’s not included, and you maybe at risk of losing your subsidies.
Republican damage control
The fallout of a Supreme Court ruling would be disastrous for everyone, but the Republicans are feeling the heat most of all. Part of the reason is that Republican governors run 26 of the 34 states that have the federal government controlling their healthcare markets, and 22 of the 24 GOP Senate seats up for election in 2016 are in those states.
The results of the Supreme Court striking down the subsidies, according to Sandy Praeger, would be “ugly.”
Praeger, a former Kansas insurance commissioner, said:
People who are reasonably healthy would just drop coverage. Only the unhealthy would keep buying health care. It would really exacerbate the problem of the cost of health insurance.
Praegar, who is a retired Republican, called it a “classic death spiral.”
If the law survives, it’s a settled law. But if it’s overturned, it’ll send shock waves coast-to-coast. The March 4 oral arguments suggest that a court divided, with Chief Justices Roberts and Kennedy as the swing votes.
The plaintiffs were hand-picked by several Libertarian and Conservative groups, so you know who to thank if you suddenly can’t afford your medication despite working two jobs and not having taken a vacation ever.
If the SCOTUS strikes down the subsidies, a number of bad things happen. Foremost, anywhere from 5 to 8.2 million Americans will suddenly lose health insurance.
Depending on how the SCOTUS rules, it could mean the end of the law entirely. Populous states like Texas, Florida, Ohio, Illinois, and others would be the most affected, and while state lawmakers can attempt to soak up the impact, the process will likely be hampered by the far right crab bucket Zeitgeist in American’s own Neanderthal country.
Also hampering the process is the timing: most state legislatures are not in session during the summer months, and even a delay in the effective date of the decision wouldn’t give state lawmakers much time to fix the problem.
Adding to this is the law’s delicate balance: Insurers can’t turn people away because of health problems under the law. The individual mandate exists to off-set this problem, requiring everyone who is healthy to contribute, with the subsidies to off-set the cost of premiums for low-income and middle-income households.
Kicking one of those out would upset the other two, and lead to an exodus from the market place of healthy people, forcing the sickly to pay more and driving up costs.
This, of course, would lead to sticker shock for the self-paying customers, like small-business owners, self-employed professionals, and early retirees. This is because the law created a big insurance pool in each state, consisting of customers who buy their policies directly and those who go through the market.
“It would set off cascading events,” said Larry Levitt of the nonpartisan Kaiser Family Foundation. “The individual market would empty out as premiums rise significantly.”
A Republican solution?
Apple watches aside, the Republicans are racing to fix the problem the only way they know how — with a band-aid:
With several Senate Republicans facing tough reelections, and control of the chamber up for grabs, 31 senators have signed on to a bill written by Sen. Ron Johnson (R-Wis.) that would restore the subsidies for current Obamacare enrollees through September 2017. But the administration would have to pay a heavy price — the bill would also repeal Obamacare’s individual and employer mandates and insurance coverage requirements.
“In that moment of what could be political chaos, we’re offering such a reasonable proposal that solves a mess,” Johnson said. “It fixes a mess caused by a sloppily written law, unlawfully implemented. All we’re asking for is a little bit of freedom back, which would be, I think, pretty popular,” Johnson said. Even Majority Leader Mitch McConnell (R-Ky.) is backing Johnson’s measure, along with the rest of the chamber’s GOP leaders.
Johnson’s biggest problems, however, are his fellow Republicans, many of whom consider expanding the subsidies to be “part of the problem.”
Meanwhile, the Republicans expect a one page fix from the Democrats ready to go as soon as the Supreme Court hands down its ruling. According to Representative Peter Roskam (R-Ill.):
If it just blows up, then the president is able to just say, ‘Here’s my remedy,’ … and we’ve got to have a substantive alternative. You want to make sure that there’s a rational transition and that we can get to a post-Obamacare era without losing whatever momentum you have in this issue.
He added that the Republican “alternative” isn’t ripe yet.
And it hasn’t been for what, eight years? Why are they expecting it now?
Featured image via Wikimedia Commons