“ObamaCare is being challenged at the Supreme Court again? What now?”
“Ah, yes, you speak of the Patient Protection and Affordable Care Act, which the then-Democrat-controlled Congress passed on a party-line vote back in 2009. It’s been the subject of lots of confusion and lawsuits ever since.”
“I thought the Supreme Court ruled on ObamaCare in 2012.”
“That ruling had to do with the constitutionality of the Affordable Care Act’s individual mandate. The federal mandate requires individuals to purchase health insurance - but the Supreme Court ruled, 5-4, that this requirement is OK because it is really a tax.”
“Congress may be incompetent in many areas, but it sure is good at creating new taxes.”
“Well, a ruling is expected this month in the case now before the Supreme Court, which has to do with health-insurance subsidies. When the bill was written in Congress, four simple words were put in: ‘established by the state’ The idea was that subsidies would only be available to people who purchase insurance in a market exchange established by their state.”
“Why would the drafters of the bill include a term like that?”
“Some suggest it was done to force states to set up ObamaCare market exchanges or risk losing federal subsidies that help those who can’t afford ObamaCare - no small number of people - afford their premiums. But 34 states still refused to set up exchanges.”
“Which means?”
“Well, since 34 states refused to set up ObamaCare exchanges, the federal government stepped into those states and set up federal exchanges that provide ObamaCare customers with federal subsidies to help them purchase ObamaCare policies. The IRS, the federal agency tasked with enforcing ObamaCare, decided to ignore the four words, ‘established by the state,’ even though they are plain as day in the law. So various states and local governments filed suits.”
“So, what happens if the Supreme Court rules that only the state-run exchanges can receive federal subsidies?”
“It means that 34 states that run only federal exchanges will no longer receive federal subsidies. Some 6.5 million people in these states will lose their subsidies and, analysts believe, many will drop their coverage due to the high costs.”
“That sounds like a disaster in the making.”
“It could lead to a ‘death spiral’ in which healthy people, who by law can now get coverage if they ever do get ill, will simply stop paying for it. They’ll buy it if they get sick. That means the people who keep their policies are more likely to be those with current health issues. Costs could spiral out of control.”
“The politicians might take some heat for that. Do you think Republicans in Congress are willing to take that heat?”
“According to The Hill, ‘House conservatives are hinting at support for a temporary extension of Obamacare subsidies if the Supreme Court cripples the law, even as they set up a working group to develop their own plan.’ They are hoping there will be a Republican president in 2017 and they will then be able to reform or replace ObamaCare.”
“It’s a heck of a mess, isn’t it?”
“Yes, it is. This is why the wiser analysts in the country pleaded with our politicians not to attempt to reform one-sixth of the U.S. economy in one fell swoop. It is why we asked that our representatives read the bill before voting on it - not pass it to find out what was in it, as Democrat Nancy Pelosi, who was then House speaker, suggested.”
“What we are finding isn’t very pretty.”
“That’s right, and it’s likely to get a lot worse before it gets better. It’s amazing, the power that our plain-written words can have over an entire country.”
Tom Purcell, author of “Misadventures of a 1970’s Childhood” and “Comical Sense: A Lone Humorist Takes on a World Gone Nutty!” is a Pittsburgh Tribune-Review humor columnist. Send comments to Tom at Tom@TomPurcell.com