Republicans’ Quicksand Stand on Obamacare

Kurt Eichenwald in Newsweek: “There’s taking a stand. Then there’s taking a stand in quicksand. And that’s where the Republican Party finds itself.”

“After almost six years of gloom-and-dooming, every intellectually honest Republican has to admit Obamacare is making life better not only for individual Americans but for the country. It is saving tax dollars, beefing up American’s monthly budget and setting the country on a path of ever-lowering deficits. Some experts are even claiming the law has improved the care in hospitals.

“The Republicans have one last shot at taking down Obamacare, and if they succeed (against all logic, reason and honesty), ugly, countrywide damage will be inflicted on the United States, and on the Republican Party. Like Napoleon’s rash attempt to conquer Russia in 1812, the GOP is lulling itself into believing that overrunning this enemy will lead to supreme victory, when in fact it is the path to self-destruction.”

“Republicans are left with deception and bumper sticker slogans to keep opposition to Obamacare going.”

“And therein lies the problem for the Republicans: If they kill Obamacare, tens of millions of people will either lose their private insurance, lose Medicaid coverage, get tossed off of their parents’ policies or be refused insurance because of preexisting conditions, and we will all see health care inflation zoom up and watch the insurance industry, which has built Obamacare into every element of its business, fall into chaos.”

“Is it really worth all of that devastation just to avoid admitting you were wrong about Obamacare?”

A Supreme Court Gutting of Obamacare Could Affect Over 8 Million

Huffington Post: “If the U.S. Supreme Court strikes down tax credits for people buying health insurance on the federal exchange, about 8.2 million Americans in 34 states could lose their coverage under the Affordable Care Act. Most of the people likely to be affected are white, employed, and low- to middle-class. They also are concentrated in a single region of the country: the South.”

“Health insurance rates in those states are expected to rise by as much as 35 percent, which may make coverage unaffordable even for those who don’t qualify for tax credits. Some believe that if the tax credits are disallowed by the Supreme Court, the underpinnings of President Barack Obama’s signature health care law would collapse.”

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“Even people who don’t qualify for the tax credits would be affected by their disappearance.  Because many of the people who receive the credits are relatively healthy, their departure from the insurance pool would lead to a 35 percent increase in premiums, according to the report.  That increase would make coverage unaffordable for about a quarter of the 4.9 million Americans who bought insurance on the federal exchange without a tax credit.”

Who Stands to Lose From SCOTUS Obamacare Case

The National Journal’s email newsletter points to “some aptly timed data from HHS: In the states using HealthCare.gov, roughly 80 percent of Obamacare enrollees–about 6.5 million people– are eligible for the premium subsidies at issue in King v. Burwell. The average tax credit is $268 per month, covering an average 72 percent of consumers’ premiums.”

The Negative Consequences of Bashing Obamacare

Robert Pear in the New York Times: “The Republicans now have realized that a court decision in their favor poses political risks to members of their party, who are frantically trying to come up with alternatives to the Affordable Care Act and a strategy to respond to such a ruling.”

“With a significant increase in their numbers on Capitol Hill, Republicans theoretically have more power to undo President Obama’s health care overhaul, but they also have more responsibility for the results.”

“Some conservatives like Thomas P. Miller of the American Enterprise Institute have been urging Republicans to devise a contingency plan that would allow consumers to keep insurance subsidies for a transition period. The existence of such a plan ‘would reassure Supreme Court justices’ that they could rule against the administration without fear of causing turmoil in insurance markets, he said.”

“Lawmakers from both parties said that repeal and replacement had become more difficult as more people gained coverage under the law and insurers found ways to profit from it.”

SCOTUS at the Front Lines of a Partisan War in Obamacare Case

Linda Greenhouse: “The new Affordable Care Act case, King v. Burwell, to be argued four weeks from now is … a case of statutory, not constitutional, interpretation. The court has permitted itself to be recruited into the front lines of a partisan war. Not only the Affordable Care Act but the court itself is in peril as a result.”

“The precise statutory issue is the validity of the Internal Revenue Service rule that makes the tax subsidies available to those who qualify by virtue of their income, regardless of whether the federal government or a state set up the exchange on which the insurance was bought.”

“But other parts of the complex and interlocking description of how the subsidies work suggest no such limitation. They point strongly in the opposite direction.”

“Statutory interpretation is something the Supreme Court does all the time, week in and week out, term after term … Every justice subscribes to the notion that statutory language has to be understood in context.”

“So will the Affordable Care Act survive its second encounter with the Roberts court? … The fate of the statute hung in the balance then and hangs in the balance today, but I mean more than that. This time, so does the honor of the Supreme Court. To reject the government’s defense of the law, the justices would have to suspend their own settled approach to statutory interpretation as well as their often-stated view of how Congress should act toward the states.”

How Many Will Die If Supreme Court Guts Obamacare?

Brian Beutler: “In a brief to the Supreme Court, dozens of public health scholars, along with the American Public Health Association, detail the harm the Court would create by ruling for the challengers in King vs. Burwell. Most of their analysis is rooted in the basic point that stripping insurance away from eight million people would dramatically impede their access to the health system. But they also flesh out the corollary argument that an adverse ruling would have deadly consequences, and ballpark the number of avoidable deaths such a ruling would cause.”

“’Researchers found that, in the first four years of the [health care reform] law in Massachusetts, for every 830 adults gaining insurance coverage there was one fewer death per year,’ the brief reads. ‘Using the national estimate that 8.2 million people can be expected to lose health insurance in the absence of subsidies on the federal marketplace, this ratio equates to over 9,800 additional Americans dying each year.'”

“The Massachusetts story wouldn’t unfold precisely in reverse everywhere the subsidies disappeared, but the experience there suggests the Supreme Court ruling would have measurable mortality implications. These costs (read: deaths) couldn’t be paired against the benefits of increased spending on anti-poverty programs. These are the costs conservatives are eager to inflict on others simply to gain the leverage they need to advance an alternative that the status quo forecloses.”

Republicans Willing to Stand Aside if SCOTUS Strikes Down Obamacare Subsidies

Wall Street Journal: “Congressional Republicans say they won’t move to preserve consumers’ health insurance tax credits if the Supreme Court strikes them down, raising the stakes in the latest legal challenge to the Affordable Care Act.”

“Leaders in the GOP-controlled House and Senate see the court challenge as their best hope for tearing apart a law they have long opposed. If the court strikes down the subsidies, Democrats are expected to clamor for lawmakers to pass a measure correcting the language in the law to revive them. Congressional Republicans say there is no possibility they would allow that.”

“A Kaiser Family Foundation poll released Wednesday found that 64% of respondents wanted Congress to take action to ensure people in all states could get financial help from the government to buy health insurance, as opposed to doing nothing.”

“GOP congressional leaders haven’t coalesced around a specific replacement for the law should the court strike down the subsidies. Democrats say that makes them vulnerable, and plan to paint the GOP as responsible for taking away benefits that millions already receive.”

Americans Still Want Obamacare Perks

Although views of Obamacare remain negative (46% have an unfavorable opinion; 40% say they favor the law) Americans want Congress to act if the Supreme Court invalidates the law’s insurance subsidies, according to a new Kaiser Family Foundation poll.

“If the Supreme Court rules that financial assistance is only available in states with state-run marketplaces, nearly two-thirds of the public says that Congress should take action so that people in all states can be eligible for financial help to purchase health insurance. Majorities of Democrats and independents say they would support Congressional action, while Republicans are more divided. And, although the Supreme Court’s decision would have significant implications for many people in states using the federal exchange, their views are similar to those of people living in states with their own marketplace.”

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A Crippling Blow to Obamacare Looms in SCOTUS Ruling

National Journal: “If the Supreme Court tears apart Obamacare this summer, the president won’t be able to put it back together all by himself … The high court is expected to rule this summer in a lawsuit over Obamacare’s insurance subsidies, which more than 80 percent of enrollees are receiving. ”

“Without a fix in Congress or a good administrative option, the only solution would be to convince the states to set up their own exchanges. That would involve convincing Republican governors and Republican-controlled state legislatures, all of whom have already refused to set up their own exchanges once, to cooperate.”

“States are going to have to establish exchanges, whatever that means. But whatever it means, it probably means the state would have to take some kind of affirmative action.”

“Because HHS had considerable flexibility in certifying state exchanges, it might be able to soften some of its standards to make it easier for states to take control of their marketplaces after a Supreme Court decision.”

“Setting up a new system for regulating insurance plans isn’t free–states that initially set up their own marketplaces were eligible for unlimited planning and establishment grants from the federal government, to help them get off the ground. But that funding has expired; states would now have to spend their own money.”

“Furthermore, the looser the standards HHS adopts, the more likely they are to draw another legal challenge.”

“It could just become a never-ending series of lawsuits.”

Who are the Losers in a SCOTUS Obamacare Subsidies Ruling?

Margot Sanger-Katz: “The people who could lose their health insurance as a result of a Supreme Court decision [in favor of the plaintiff in King v. Burwell] are predominantly white, Southern, employed and middle-aged, according to an Urban Institute analysis.”

The groups that have gained the most from Obamacare so far are “blacks, Hispanics, young adults, rural Americans and those with the lowest incomes. But the group that stands to lose the most from the court case has a markedly different profile.”

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“The new Urban study finds that the biggest regional loser from the court case would be the South. More than 60 percent of people who would lose their individual health insurance live there. Among different income groups, the largest reductions would come for those earning between 200 and 400 percent of the federal poverty level — or between about $40,000 and $80,000 for a family of three. Forty-seven percent of the people who would lose insurance have full-time jobs, and 34 percent have part-time jobs. Sixty-one percent are white. Forty-seven percent have attended at least some college. Ninety-two percent would probably describe their health as better than fair.”


Obamacare Wish May Doom Republicans in 2016

Talking Points Memo: “A Supreme Court decision to overturn Obamacare subsidies would directly affect millions of Americans in key swing states and pose a political dilemma for Republicans ahead of the 2016 election — at least unless they can get behind a viable health care alternative.”

“A ruling in the looming case King v. Burwell could wipe out health insurance subsidies for some 3 million Americans in a dozen states that could decide the 2016 election and rely on the federal HealthCare.gov exchange, according to new research by professors Theda Skocpol of Harvard University and Lawrence R. Jacobs of the University of Minnesota.”

“In Florida, nearly 1.2 million Americans are enrolled in a federal exchange plan as of early 2015. In Ohio, Virginia, Pennsylvania, New Hampshire and North Carolina a total of 1.3 million Americans would lose their plans. Notably, in each of those states the number of federal exchange customers who risk becoming ineligible for subsidies exceeded the 2012 presidential election winner’s margin of victory in that state, Skocpol and Jacobs found.”

“Ironically, the negative consequences of a Supreme Court ruling to restrict the subsidies would be most prevalent in Republican-heavy states, which overwhelmingly refused to build their own exchanges.”