By Tom Baxter
Until the U.S. Supreme Court rules in the case of King v. Burwell, the fate of ObamaCare, and indeed the condition of American politics in general, will be a little like a luxury liner sailing in the general direction of an iceberg. No one can say with certainty whether disaster is in the offing, nor can it be predicted who’s most likely to get wet.
The ruling, expected this summer, will determine whether some 7.5 million Americans in 34 states which have not set up their own health insurance exchanges can continue to receive federal subsidies to buy insurance under the Affordable Care Act. That’s because the case deals narrowly with whether the wording of the law allows for the subsidies to be offered on the federal exchange.
It’s hard to imagine a ruling with pricklier political implications. Those directly affected by the ruling generally live where resistance to ObamaCare has been strongest, but also where enrollment in the federal health insurance exchange has been heavy. A recent Stateline analysis found that 62 percent of those who would lose their health care subsidies live in the South. Sixty-one percent are non-Hispanic whites, 71 percent work at least part-time and 82 percent earn above the federal poverty level.
Worried about the implications of the ruling in states which could be vital to the GOP’s political prospects, the Senate Republican leadership last week introduced a bill which would extend the ObamaCare subsidies until the middle of 2017, well past the next election.
This has drawn the inevitable howls from anti-ObamaCare diehards, already feeling the earth slipping beneath their feet.
“Let ObamaCare’s Subsidy Victims Suffer,” the American Spectator’s David Catron advised this week.
“It is eminently possible that the Court will rule against the Obama administration, and this will leave millions of ObamaCare enrollees in the lurch. It is, however, far less likely that the wrath of these ObamaCare victims will be directed at Republicans, assuming the GOP handles itself with intestinal fortitude and intelligence,” Catron wrote.
It’s Catron’s belief that voters who lose their health insurance will blame Democrats for a “sloppily written law” rather than Republicans who opposed the law which gave them the insurance. Given the demographics, that may indeed be the case with many voters. But they would overwhelmingly be Republican voters already.
On the flip side, the Democratic blogger Josh Marshall has pointed out that several of the key 2016 swing states, including Florida, Missouri, Ohio and Virginia, are among those affected. This makes it unlikely the GOP leadership will adopt a let-them-eat-cake strategy, though it must continually appease those who would have it so.
The die-hards won a victory Monday when the Republican leadership adopted a legislative blueprint for the budget which would make it easier to get a Congressional repeal of the law on the president’s desk, for his certain veto. But this is part of what by now has become an entirely symbolic exercise.
The best evidence for the durability of the Affordable Care Act is the bill Senate Republicans are drafting to replace it. It would create tax subsidies much like those at issue in King v. Burwell, bar insurance companies from creating lifetime limits or denying coverage for pre-existing conditions, and allow parents to include their children in their plans up to age 26. It has been called ObamaCare Lite, but it’s not even so lite, if you think about how much of the Affordable Care Act is now accepted by its stoutest critics.
Although opinions on ObamaCare still trend slightly negative, its popularity has improved steadily since the disastrous rollout of the healthcare.gov website in November, 2013. This has coincided with the elimination of more than 16 million Americans from the ranks of the uninsured, a 20 percent drop in hospital costs related to the uninsured, and the news that the law is on track to cost $600 billion less than expected in this decade. Not bad, for such a sloppily written law.