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Waiting for SCOTUS: King v. Burwell

Waiting for SCOTUS: King v. Burwell

What comes after?

Republicans are in a pickle, and have been since the moment Obamacare was passed.

You might think they’re in a good position, because the Supreme Court is considering overturning the state Obamacare exchanges and subsidies because of wording in the statute, and this would throw the entire Obamacare system into turmoil. The case in question is King v. Burwell, and it could be decided any day now.

But there’s one catch, and it’s a biggee: if the ruling goes against Obamacare, the press and the left will rail at the Republicans for being the big bad meanies who took away a lot of people’s subsidies. That was part of the beauty of Obamacare for the left, and one of the many many reasons they were so extraordinarily eager to pass it and pass it as quickly as possible: they wanted to create a dependence and an expectation, otherwise known as an entitlement, that would be tremendously hard to reverse.

But what do the American people actually want if SCOTUS throws out the state exchanges and therefore the state subsidies? A substantial majority appear to want Congress to fix Obamacare rather than re-establish the state exchanges, according to this poll. But what would that actually look like?

Some indications here* (and the whole thing is worth reading for more details):

Voters view ObamaCare as having done more harm than good. They blame Congress for a poorly written law and they expect Congress to fix it. And they want those fixes to help everyone, not just those getting subsidies. They want those changes to make sense: more choices, the ability to buy insurance any time, and subsidies that follow people, not just exchange plans.

Voters understand that setting up ObamaCare exchanges will put states on the hook for the high operating costs to run those exchanges. They recognize that doing so will put more employers and individuals at the mercy of the IRS as it enforces more ObamaCare mandates. And they’ve seen the disastrous rollouts other states have experienced in setting up those exchanges. This is a problem created by the federal government. They don’t expect or want states to bail out Congress to vote against their state lawmakers the next time they’re up for re-election if they set up a state exchange.

But why, if Congress was so bad at setting up Obamacare in the first place, would it be so good at fixing it? And that’s true even though the first feat was accomplished by Democrats and the second would be performed by Republicans, because we know that the latter aren’t necessarily so great, either. Another thing the poll indicates is that respondents still seem wedded to subsidies, they just want them to not be tied so closely to policies sold on an exchange.

Those who say Republicans have no plan are right in that they have no unified and universally agreed-on plan, but they certainly have no lack of plans, plural. A new one was recently outlined by Louisiana Senator Bill Cassidy, who is a doctor. The entire article is worth reading, but here’s an excerpt (and I think Cassidy’s statements are interesting not only for his plan itself but for the reasoning behind it):

Freshman Sen. Bill Cassidy (R., La.) wants the GOP to start thinking like the left.

In proposing the Patient Freedom Act, Cassidy believes he is doing just that—slowly chipping away at Obamacare by bringing federalism back into the health care system and getting the federal government out.

“Of course it would be wonderful [to repeal Obamacare now],” Cassidy told the Washington Free Beacon. “But as Paul Ryan says, President Obama is not going to sign a repeal of Obamacare.”

“The left was really good for decades—they were pushing, and pushing, and pushing [for health care reform],” Cassidy said. “We’re impatient. We want it all at once.”

“I think we have to be as strategic as they,” he said. “Plant those seeds, water, show people our alternative, and inch back.”

Cassidy…narrowly focused his bill to be a response to a ruling in favor of Burwell, which would take away subsidies in states that are operated by the federal exchange….

[Cassidy’s] Patient Freedom Act would give states the option of keeping Obamacare by establishing a state-based exchange, or using existing funding to provide tax credits to create Health Savings Accounts (HSAs) for the uninsured, averaging $1,500 per person…

“The president, I’m sure, will make it easy [to set up a state exchange], because he wants his law to take root,” he said. “If we don’t have a better plan, it will take root.”

If states chose Cassidy’s option, they could do away with various mandates under Obamacare, including the individual and employer mandates and requirements for minimum essential coverage. The legislation would also equalize tax treatment, and require health providers to publish cash prices for services reimbursed from an HSA…

Cassidy’s bill borrows from other Republican alternatives to Obamacare in Congress, such as Rep. Tom Price (R., Ga.), whose replacement plan also offers tax credits. Cassidy said his is the only plan that would solve the gap in coverage if the Supreme Court does away with Obamacare subsidies.

Note also Cassidy’s statement about Obama wanting his law to “take root.” That’s exactly the sort of thing that happens with entitlements—they take root, and the roots are thick, deep, and tangled. Good luck pulling them out.

[* NOTE: One thing I noticed about the poll is that the demographics are based on the voting in the 2014 election. But the 2014 election was atypically small and atypically Republican, so the poll probably skews to the right.]

[Neo-neocon is a writer with degrees in law and family therapy, who blogs at neo-neocon.]

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Comments

Freddie Sykes | June 4, 2015 at 12:42 pm

To “fix” Obamacare would mean that the whole law would be subject to a rewrite. The Republicans will have to pass something but we know Obama will veto any meaningful reforms.

Then it’s back to you Barry.

The ball-less Republicans will punt on this. Empty promises, broken promises.
Repeal 0bamaCare – they refuse to do it.
Build a border fence – they refuse to do it.

Most Congressional Republicans wear “small hotel” pants – and we all know a small hotel has no ballroom.

Golly, like most things…especially Collectivist tainted things…there are some things to suss out.

It isn’t rocket surgery, however. A tiny bit of creativity and situational awareness will carry the day. I recommend the “leadership” in the GOP turn the matter over to our young representatives and senators who have combat experience.

I’m dead serious.

There are 8 enumerated powers given to the fed gov. The feds have stretched their power beyond what is sustainable so one way or another, the entitlements will all go.

    Ragspierre in reply to showtime8. | June 4, 2015 at 1:27 pm

    Yeeeeup. As I’ve said before, we either chose to deal with this catastrophically or rationally. That’s the ONLY choice here.

    So far, we have chosen catastrophically.

American Human | June 4, 2015 at 1:33 pm

So Republicans, who had nothing to do with this bill, are going to just sit around and moan and groan how it is so unfair that the MSM is blaming all of this on them?
Instead, take some of those $$millions donated and start a PR campaign to tell the TRUTH. The MSM won’t so why worry about what they are saying. Buy space in papers across the country, buy time on TV and radio, hold press conferences, Now Now Now. Be freaking pro-active about this. Start point the finger toward those responsible in the first place NOW!!! Don’t wait until SCOTUS decides, do it NOW!!!

    DaveGinOly in reply to American Human. | June 5, 2015 at 12:26 am

    You’re quite correct. The message should be that the Left wrote the legislation, put that clause into it, passed it, and it was signed into law by their own president. They own it. But we all know how bad the Republicans are about conveying their message to the people.

Obama has vastly embiggened the Free Stuff Army, and if there’s one thing the Free Stuff Army will fight against, it’s anyone who threatens to take away their newly-bequeathed Free Stuff.

Nearly 90% of Obamacare enrollees are receiving subsidies. Who wants to be the Mean Ol’ Meany who dares to tell them to put their hands back in their own pockets and stop looking to Other People to pay their way?

They need to point out that Obamacare only helps 6-8 million people. It harms everyone else. If you add up the new deductibles mandated, co-pays mandated, extravagant non essential services mandated, and the extortionate premiums now going into effect, it would be cheaper just to buy basic insurance for the Obamacare crowd excluding illegal aliens of course. Do your PR work Republicans.

You might also note that the poll was only in states that did not setup an Obamacare exchange, which would overwhelm the 2014 voter bias and invalidate any generalized claims that it represents what “the American people” actually want.

Establish every citizen, alien (legal and illegal), as a sovereign entity with an open credit line. The federal government under Obama’s direction has demonstrated that wealth and debt have equal value. This implies that production and service can be decoupled, and debt can be substituted for wealth.

No more budgets. Unlimited resources. End of poverty, right?

Subotai Bahadur | June 4, 2015 at 3:15 pm

There is nothing so permanent as a “temporary” government program, subsidy, benefit, or tax. Any “Republicans” voting for the temporary extension of the subsidy are voting for making Obamacare permanent. The DIABLO’s are about to directly write off their own voters permanently at the same time.

The DIABLO’s are acting like they are dead sure that there is nothing that they can do that will remove them from office. Almost like they know that there will not be any elections in 2016, and those who are incumbents will remain.

If there are elections in 2016, I wonder who they think is going to be doing the work of GOTV, local campaigning, etc. for them? Because those of us who did it in 2014 sure aren’t.

I’d love to see Obamacare go away. I’d also love to see all the silly assed insurance mandates and premium increases go away as well. As a self-employed person, Obama and the democrats really screwed me over. I’d much rather be saving more for retirement instead of paying more for a crap insurance policy that I don’t want and don’t need.

Henry Hawkins | June 4, 2015 at 6:05 pm

Back the camera up when we view the subject of health insurance in America – unless and until something is done about skyrocketing medical costs, no mere payment program is going to work, they’ll all go bankrupt.

It’s sort of like how there’s no point in reforming immigration law unless we close the southern border and close the work visa overstay issues. There’s no point in designing or reforming health insurance subsidy programs, existing or proposed, unless medical costs are gotten in hand. How can a program work if you have no idea what future costs will be, beyond knowing they are and will continue to skyrocket unpredictably?

    FrankNatoli in reply to Henry Hawkins. | June 5, 2015 at 9:50 am

    The only way costs are controlled in any business is through competition. Competition gets you the best product at the lowest cost. Absence of competition, and big government is the ultimate absence of competition, gets you the worst product at the highest cost. We’ve got to get almost all of government out of health care and almost all of government out of health insurance.

There is a simple solution that Republicans will not even attempt.

Step 1: Ignore what the court rules in Burwell.
Step 2: Pass a law allowing people to buy insurance across state lines, even if it does not meet the standards of Obamacare.
Step 3: When Obama vetoes it, point out that he’s keeping prices high and making it hard for people who don’t get subsidies to afford insurance.
Step 4: Attempt to overturn the veto.
Step 5: When the overturn attempt fails, weep and wail about how the Democrats want people to die because they can’t pay for food and housing after their mandatory insurance has siphoned off all their money. (Don’t talk about business owners or the middle class. There’s no need to be that specific. This stuff is hurting everybody)
Step 6: Pass it again (go back to step 2)

Rinse, repeat until there’s a Republican president who’ll sign the bill.

Trusting the court or Obama to do the right thing won’t work and trying to do something Obama might accept will just make the voters angry, and make it that much harder to get a Republican into the White House next year.

My way works but it does require that they not surrender. Sigh. Too bad surrender is the only plan they understand.

    DaveGinOly in reply to irv. | June 5, 2015 at 12:34 am

    An ingenious plan, and one that results in nationalized health care (like we effectively have now). Is that something we’ve decided we wanted? I thought we wanted a free market solution?

    This is how the Left wins nearly every engagement. They propose something crappy and socialist, and the Republicans propose something slightly less crappy and slightly less socialist. So even when the Republicans “win” the country is pulled to the left and the Progressives win yet another round. The best way to deal with a bad idea is to oppose it on principle, not to replace it with another (slightly less) bad idea. Although such opposition may not be popular, and may not get conservatives elected, any other course results in a continuous drift to an all-powerful Marxist state. Republicans should spend their efforts competing against the Left, instead of with them. This may cause them to loose power, but at least they won’t be contributing to the nation’s destruction.

    FrankNatoli in reply to irv. | June 5, 2015 at 9:46 am

    Let’s be precise about “buying across state lines”. United Healthcare, the largest, is based in Minnesota, yet offers plans in all 50 states [57 if you’re presently toking the line at 1600 Pennsylvania Avenue]. The problem isn’t “buying across state lines”. The problem is state regulations that inflate minimum policy requirements beyond what most people can afford. There is a valid role for the state in insurance. Insurers are not saints. Insurers cannot be permitted to drop individual the moment they become seriously ill, nor be permitted to hammer individuals as they age with unaffordable premiums. But the vast majority of state regulation is special interest related. Get rid of it.

FrankNatoli | June 5, 2015 at 9:34 am

Well, if they were smart and conservative, they’d unite behind this:
http://rsc.flores.house.gov/solutions/rsc-betterway.htm
But they’re not smart. And they’re not conservative.

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