Careful guys, your callousness is showing.
The Obamacare "replacement" plans put foward last week by presidential would-bes Scott Walker and Marco Rubio have one major thing, and very Republican, thing in common: they hurt poor and middle-income Americans at the expense of the rich
. As usual. Hurting the low- and middle-income folks is actually pretty much baked-in to the entire Republican response to everything, but particularly Obamacare. Sarah Kilff has just one more example of that
in the form of the lawsuit House Republicans have brought against President Obama over the law.
The Republicans argue that the administration broke the law by sending money in the form of cost-sharing subsidies to insurance companies—money that Congress did not authorize. The case has troubling implications for legislative-executive processes if it advances past the federal district court in Washington, DC, where it is now. But setting that aside, it's what it would do to the subsidies that are making keeping insurance even remotely affordable for millions of people that's the issue here. At issue aren't the subsidies to purchase insurance, but assistance to low-income Obamacare enrollees to pay for other insurance costs, like co-pays and deductibles. The large majority of people getting the help fall solidly in the lower- and middle-income brackets.
Obamacare enrollees who earn between 100 and 250 percent of the federal poverty line ($29,425 for an individual; $60,625 for a family of four) qualify for cost-sharing subsidies. About 65 percent of Obamacare enrollees fall into that category, according to research firm Avalere Health—and 5.9 million people currently use them.
The cost-sharing subsidies reduce enrollees' costs in two ways. First, people with cost-sharing subsidies get lower limits on their out-of-pocket maximums. The limit is on a sliding scale by income. […]
Second, Obamacare requires insurance plans to craft different coverage plans for people buying with cost-sharing subsidies. These plans must cover a bigger chunk of an average enrollee's bills and usually do this with lower deductibles and co-payments.
The average Obamacare plan for someone without a cost-sharing subsidy, for example, charges $318 for an emergency room visit. But for the lowest-earning Obamacare enrollees who do get cost-sharing subsidies (the people who earn between 100 and 150 percent of the poverty line), that drops to $168.
Republicans are arguing that this assistance is illegal, and they want to take it away. Unlike the challenge to the individual mandate that everyone have insurance, or the King
case that would have taken subsidies away from everyone using the federal health insurance exchange, this challenge wouldn't necessarily cripple Obamacare. But it would make it expensive for the people who need assistance to even get insurance to use that insurance. That's 5.9 million people who would be left paying for something they probably wouldn't be able to use, or if they're at the lower end of income, or really sick once again out of reach.
But that's a feature, not a bug, of this latest Republican attack on the law. Because the people that it would hurt aren't the people that matter to them.