Thursday, May 28, 2015

Anxieties Mount as Supreme Court Decision Approaches

If writers of health law had it to do over again, they would undoubtedly not use the 4 words “established by the state.” These 4 words are the basis for plaintiffs’ suit in King v. Burwell, and for anxieties should the Justices rule against ObamaCare. It may the 4 words are, as health law’s writers now claim, were “inadvertent,” “inartful,” “in error,” “inexplicable,” “just a mistake,” or “what was said want not what was meant,” but as Justice Antonin Scalia commented, “What matters is not what Congress would have wanted but what was enacted.”

What matters now is how voters will react in 2016 when they know the impact of the Court’s ruling on 7.7 million with federal subsidies, on 2.85 million with state subsidies, on 1.14 million on health exchanges who did not qualify for subsidies. If federal subsidies go by the board, subsidy holders will see premiums go up by these amounts: Miss. 774%, Alaska 449%, Ga 364%, Maine 347%, Fla., 338%, Molm, 330%, N.C. 317%, S.C. 314%, Wyo. 313%, and La.298% (Source: Avelere Health). If the Court upholds the lawsuit, monthly costs for those with subsidies will climb from $100 to about $350. And for the rest of us under 65 not on Medicaid or Medicare, we will see average family deductibles for an ObamaCare bronze plan i $10,545 and for a silver plan $6,010.

As healthy consumers forgo buying health insurance, and the sick hold on to their policies, we may see a collapse of the insurance industry, the so called death spiral.

How did this happen? Well, there’s the faulty wording of the law. But there’s also the mandate for broader coverage covering 10 essential benefits, and the fact that insurers can no longer exclude maternity, mental health, prescription benefits and cannot deny coverage for or charge more for someone with a pre-existing condition.

The Obama administration has reacted by offering no backup plan, reasoning that no compassionate Justice would deny subsidies to those who need it. The GOP is scrambling to come up with an alternative plan, such as allowing those with subsidies to keep their subsidies through 2017, until after the elections.

This Court’s decision sets up the potential for a bitter political battle whatever the decision. In the meantime, until the decision is rendered a month from now, the writers of the health law are saying the drafting of the law was “sloppy,” an overlooked “typo, “ for which nobody need claim responsibility. The important lesson here is to say what you mean, not say what you think you meant to say.

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