How's he going to buy this load?
Comments from the architect of the
King v. Burwell challenge this week might just completely undermine Republicans' victory in the case. Congressional Republicans have been playing a
ridiculous farce for the Supreme Court. They're pretending that they're working really hard to come up with an alternative they can put in place if the court decides to strike down federal subsidies to people buying insurance on the federal exchange. They've had a hard enough time making that seem plausible when
their own members undercut it, and when the House
keeps on having those repeal votes.
Now the farce has also been exposed by Michael Cannon of the Cato Institute, one of the guys who came up with this challenge, in a debate at Georgetown University law debate Wednesday. Brian Beutler has the details.
"There are two ways to correct this imbalance," Cannon said. "One of them is, and my preferred way is, you get rid of those subsidies and mandates so that the law is not making health insurance so expensive for the majority of these folks in healthcare.gov anymore. That is basically repeal. Repeal is relief for the vast majority of people in the exchanges, and you would want to do something to help those who could not then afford health insurance on their own. And I think that's what the Republicans in Congress will want to do."
Cannon went on:
"What the administration will want them to do is reinstate those subsidies…. That is very unlikely to happen. Another possible outcome is that states could establish exchanges, and therefore get those subsidies flowing again. That is also very unlikely to happen for reasons similar to why Congress is unlikely to do that. We're talking about Republican office holders who are not going to be eager to expand the ACA, increase government taxes, spending and deficits, and impose the individual and employer mandates on millions of people. And give Obamacare their imprimatur. So there could be a standoff. We don't know how long that would last."
Rep. Paul Ryan, who is supposedly working feverishly on a replacement plan,
confirmed Friday that the subsidies will not be fixed, and that the Republican
intent is to give states more freedom "to get out of Obamacare." In other words, states will be able to wash their hands of Obamacare totally, just like they did with Medicaid expansion. Which Cannon says is the likeliest outcome as well, if he wins this case.
Now, Cannon's job is convincing five Supreme Court justices of his idea that there will be cheaper health insurance when they "get rid of those subsidies and mandates so that the law is not making health insurance so expensive for the majority of these folks in healthcare.gov anymore." No, there's no logic there so don't even try to figure it out. Remember that the suit is premised on the idea that people are forced to buy insurance that is expensive because the government is forcing money on them to pay for it. If you take away the free money then you take away the mandate and all of the sudden insurance is cheaper, Cannon is arguing.
Never mind that every health economist argues the opposite, as does reality, unless you make the leap that all of the obligations of health insurance companies are also repealed. If health insurers are still required to take all customers—including the really sick, expensive ones—and they are losing healthy people who can't afford to pay premiums without the subsidies, then premiums are going to skyrocket. That scenario could only be avoided with legislative repeal of the whole law, which is not happening, but which would also throw us back into the pre-Obamacare days of very high uninsured rates.
That's an awful lot for a Supreme Court justice to swallow, knowing that the likeliest outcome of his ruling for Cannon's clients is returning to the totally broken healthcare system we had before the law. Worse, it means taking health insurance away from millions of people who are probably pretty damned happy to finally have it.