by Madeleine Kando
The Affordable Care Act, also known as Obamacare, is once again under attack by Republicans. Since its birth in 2010, they have tried to dismantle it, either piecemeal or as a whole, and have taken every opportunity to badmouth it, without offering any significant alternatives.
They first derided the ACA by pointing to the many technical problems that the healthcare.gov website suffered from, which caused a bunch of delays. But when those problems got fixed and enrollment surpassed expectations, proving that Obamacare was a good thing, Republicans decided to challenge the constitutionality of the whole Act. When the United States Supreme Court upheld the Individual Mandate, they went after some of the provisions of the Act.
In Hobby Lobby vs. Burwell, the Supreme Court ruled that requiring family-owned corporations to pay for insurance coverage for certain forms of contraception under the Affordable Care Act violated a federal law protecting religious freedom. Obamacare lost on that front.
The current attack has to do with what Paul Krugman describes as 'an obvious typo' in one clause of the Affordable Care Act. In 'King vs. Burwell', the plaintiffs challenge the constitutionality of tax credits for premiums. As written, the law only allows exchanges "established by a state" to administer these subsidies. If the federal government set up the exchange (as it has done in most states), then it would not have the authority to administer a crucial part of the Affordable Care Act.
Many states, mainly conservative ones, have refused to set up their own exchanges, and defaulted to exchanges run by the federal government. According to the lawsuit, the subsidies are lawful only in the states that decided to set up and operate their own exchanges. So, if you look at the specific language authorizing those subsidies, ‘it could be taken — by an incredibly hostile reader — to say that they’re available only to Americans using state-run exchanges, not to those using the federal exchanges.' (quoted from Paul Krugman's article).
But you don't have to be a genius to understands that the ACA did not mean to provide affordable health care only to those Americans who live in states that set up their own exchanges. The subtitle of the Affordable Care Act which contains the provision plaintiffs rely upon is titled “Affordable Coverage Choices for ALL Americans."
The irony is that if the Court declares the subsidies illegal in the states that have federally run exchanges, we could see a two-tiered system of health care develop: the states that have their own exchanges (mostly Democratic states) will keep their subsidies for middle income families, and the states with federal exchanges (mostly Republican states) will lose their subsidies and millions of Americans won't be able to afford health insurance. The mostly Republican constituency will become the victim of its own idiotic shenanigans. The states with the highest percentage of insured who qualify for subsidies would loose out. And those are Republican states.
The 3 legged stool that Obamacare is built on, (1) no denial of coverage for pre-existing conditions, (2) everyone has to have insurance, and (3) subsidies for those who cannot it, would suddenly miss one of its legs.
If subsidies are taken away from the newly insured in the 34 states that have federally run exchanges, most of them—especially the young and healthy ones—would drop coverage. A sicker pool of consumers results in higher premiums, which causes more people to drop out, which in turn results in a further increase in premiums, etc. The whole system collapses.
The stupidity of it all boggles the mind. It is also unbelievably mean spirited. To deny health insurance to people who need it the most because of a typo?
How does a rational person explain this latest development? The Affordable Care Act is one of the best things that has happened to this country for a long time and Americans are starting to realize this. It is imperfect, for sure, but dismantling it, especially without having anything to replace it, all in the name of liberty, is the most stupid thing we can do. If the Supreme Court upholds King vs. Burwell, it puts the engine in reverse, after 18 million previously uninsured people have signed up for Obamacare. It has become part of our reality. Would such a decision not cause enormous chaos?
According to a leading Market Research Company, 'Ipsos MORI', who created an Ignorance Index that compares 14 countries on how much citizens know about their country's social affairs, the United States is the second most ignorant country, behind Italy. Is that why we always vote against our own interests? Rather than waste taxpayer dollars on fighting Obamacare, we should spend our time on how best to use exchanges to improve insurance markets and health system performance.
Republicans should be careful what they wish for. If King vs. Burwell is upheld, it is sure to backfire. They will be blamed for injuring millions in their own states. Now that elections are not too far in the future, is this really what Republicans want? leave comment here
The 3 legged stool that Obamacare is built on, (1) no denial of coverage for pre-existing conditions, (2) everyone has to have insurance, and (3) subsidies for those who cannot it, would suddenly miss one of its legs.
If subsidies are taken away from the newly insured in the 34 states that have federally run exchanges, most of them—especially the young and healthy ones—would drop coverage. A sicker pool of consumers results in higher premiums, which causes more people to drop out, which in turn results in a further increase in premiums, etc. The whole system collapses.
The stupidity of it all boggles the mind. It is also unbelievably mean spirited. To deny health insurance to people who need it the most because of a typo?
How does a rational person explain this latest development? The Affordable Care Act is one of the best things that has happened to this country for a long time and Americans are starting to realize this. It is imperfect, for sure, but dismantling it, especially without having anything to replace it, all in the name of liberty, is the most stupid thing we can do. If the Supreme Court upholds King vs. Burwell, it puts the engine in reverse, after 18 million previously uninsured people have signed up for Obamacare. It has become part of our reality. Would such a decision not cause enormous chaos?
According to a leading Market Research Company, 'Ipsos MORI', who created an Ignorance Index that compares 14 countries on how much citizens know about their country's social affairs, the United States is the second most ignorant country, behind Italy. Is that why we always vote against our own interests? Rather than waste taxpayer dollars on fighting Obamacare, we should spend our time on how best to use exchanges to improve insurance markets and health system performance.
Republicans should be careful what they wish for. If King vs. Burwell is upheld, it is sure to backfire. They will be blamed for injuring millions in their own states. Now that elections are not too far in the future, is this really what Republicans want? leave comment here
4 comments:
Obamacare sucks because it's a halfass solution. I'm a conservative but understand that medical is not a service that should be subject to the free market. Obamacare was designed to make nobody happy & should be scrapped for full socialized medicine. It was designed to fail so that republicans could then claim that socialized medicine doesn't work, and Obama like a dope walked right into the trap. Did he really think that "If you like your insurance you can keep your insurance" wouldn't bite him & his party in the ass? Did he really think he could continue to hide that he taxed the insured to pay for the uninsured? What an astounding combination of hubris & idiocy. People need to stop defending him because he's black & of your party it's pathetic already.
Despite the ravings of Mr. Krugman the problem with the ACA statute on reimbursements was not a "typo", it was a mistake. What you are asking for is a "do over" - In legislation, when the courts find obvious errors like these - the do over is to correct the legislation. This would not have been necessary if the Democrats had not been so hell bent to pass a bill.
Based on the first six months of the GOP control of the Senate, if the decision is sustained, as it should be, it is likely that we will finally be able to get some intelligent and bipartisan discussion about what role government should have in our healthcare system.
Jonathan:
Why would Congress go through the trouble of creating an unworkable system? If policies purchased on a federal exchange did not qualify for subsidies and enough states did not establish exchanges, the ACA scheme would fall apart.
In Section 1321 (c)(1)(B) it says that if a State fails to establish an exchange 'the Secretary shall directly establish and operate such Exchange within the State.' It's hard to believe that Congress would not incorporate ALL the features that characterizes an exchange, including subsidies, just because it is now in charge of such Exchange.
Focusing on Section 1401 at the exclusion of Section 1321, which makes the ACA's intent regarding subsidies very clear, distorts the truth.
You are the “halfass.” You are angry because you realize that you are wrong, that you have been wrong all along and that you don’t have a clue of a solution. You have been brainwashed, like millions of other ignoramuses.
Conservatives and Republicans never had any intention to provide universal and mandatory health insurance, as exists in all civilized countries. Ever since Obamacare passed, they have been claiming that they want to “improve” it, not abolish it. That’s a lie. Had they truly wanted some form of national health insurance, they could have done it as far back as Richard Nixon, who already wanted to do it.
Obama didn’t walk into any “trap.” He introduced universal mandatory health insurance for the first time in this country. A giant step forward.
Taxing the insured to pay for the uninsured? You mean taxing the healthy to help the sick. That’s the only way civilization can work. We all pay car insurance, even though the vast majority of us don’t get in car accidents.
Hubris and idiocy? Sure, just like George Washington, Abraham Lincoln, FDR and the other great leaders who had the courage to advance the country, despite reactionary obstructionism and massive ignorance around them, too...
You HAD to bring race in, didn’t you? That shows what’s on your mind, no matter how much you’ll deny it…
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