Next month, the Supreme Court of the United States will consider
King v. Burwell, in which millions of people will be affected.…
This past week, house repugicans voted for the 56th
time to take healthcare away from 10 million Americans. To be sure,
that vote was mere theater to humor the repugican base because even if
or when it gets through the McConnell senate, President Obama will veto
the bill.
However, the repugicans aren’t limiting their war
with the health and lives of millions of Americans to political
theater. Next month, the Supreme Court of the United States will
consider King v. Burwell, in which millions of people will be
affected. The Court will consider if the ACA originally intended to
restrict subsidies to people in states that set up their own exchanges.
This is the third time the Supreme Court is considering a case in which
the goal was to take healthcare away from millions of Americans.
When it comes to providing access to affordable
healthcare, even with the Affordable Care Act, America lags behind other
nations. No doubt, the ACA is a vast improvement over corporate death
panels, the blackballing of people with pre-existing conditions and the
inherent sexism in which women were charged higher premiums simply
because we are women.
Ultimately, the Affordable Care Act is the health
care system that repugicans loved before it became the compromise that
President Barack Obama accepted as an alternative to doing nothing.
Since then repugicans compared the ACA to slavery
and the Holocaust, while offering nothing that addresses the fact that
corporate death and sick care is not healthcare. The irony is for profit
healthcare does the very things repugicans try to attribute to the
ACA.
Should King prevail in the Supreme Court, people who
live in states that didn’t set up their own exchanges will cease to be
eligible for Federal subsidies. In turn that will drive up insurance
costs for people in states with exchanges, and therefore make healthcare
security a thing of the past for them.
Healthcare insecurity means people put off going to
the doctor until whatever ails them becomes unbearable, potentially
deadly and without question more expensive to treat. It means a return
to the days of the clinic of last resort – the emergency room where
healthcare is also the most expensive.)
The plaintiff in this case, is 64 year old David M.
King, who, with an income of $39,000, cannot afford the market based
healthcare his cabal believes in. In her profile of King,
Jennifer Haberkorn of Politico said:
A review of King’s
public social media accounts show he is a proud grandfather who loves
his family, enjoys cooking and sharing photos from conservative blogs.
One image shows a photo from the movie “Back to the Future” with
instructions to the time traveler: “Marty, there is no time to lose. You
must go back in time and give Obama’s dad a condom.
Obviously, King has little to gain accept “freedom”
from access to healthcare. However, King personifies the very thing
that is wrong with that system. Not only is he financially precluded
from buying “market based” healthcare, it is highly probable that the
rest of us will end up picking up the tab for his healthcare expenses.
He argues that this is about his freedom of choice
and getting away from the “tyranny” of government subsidies that would
make healthcare accessible to him and would entail that he pay something
based on his ability to pay. He’s wrong.
This is about what his suit does to the 13 million
Americans who want healthcare security but were denied the freedom to
make that choice under the old system, be it because they couldn’t
afford it or because they had pre-existing conditions.
Not that King’s motive will or should matter to the
Supreme Court. However, even if one wants to be charitable to his
contention that the ACA only allows federal subsidies to people in state
based exchanges, it doesn’t work.
The text that King relies on to make his case is 26 U.S.C. § 36B(c)(2)(A)(i) which says:
the monthly premiums
for such month for 1 or more qualified health plans offered in the
individual market within a State which cover the taxpayer, the
taxpayer’s spouse, or any dependent (as defined in section
152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311
[1] of the Patient Protection and Affordable Care Act,
The IRS interpreted that to mean that people who get
healthcare through state exchanges or the federal exchange and are
eligible for subsidies can get them. King (and his friends) hinge their
argument on a “plain reading” of the law. Even then, King’s argument
doesn’t work.
For one thing, King (and his supporters) claim that a
letter
by Democrats proves King’s claim regarding the original intent of the
ACA. However, even the most literal interpretation of that letter
suggests that King (and his backers) are grasping at straws.
You can read the letter in its entirety and judge
for yourself at the link above if you wish. In my reading, the letter,
actually suggests an intent to assure that people living in
obstructionist states can still benefit from what is, in reality, a
national program – including eligibility for subsidies.
It begins with recognizing that some states will
refuse to set up state exchanges and goes on to the ways that can be
addressed. Eventually it gets to the point of discussing a federal
exchange and that exchange’s ability to administer “federal
affordability credits.”
Reforming our nation’s
health care system is a national effort that requires a national
solution, not a piecemeal approach. A single, national health insurance
exchange will not only administer federal affordability credits and
receive federal start-up funds, but will also be charged with enforcing
federal laws and regulations. As the Commonwealth Fund recently
reported, a single, national health insurance exchange would ensure
uniform, national availability of health insurance plans, better serve
consumers, and have the resources to appropriately regulate insurers.
Think Progress asked
the letter’s author, Representative Lloyd Doggett (D-Tx) via email what he and
his cosigners meant in the letter. Here is what he is reported to have
said:
Doggett replied that he and his ten colleagues
“neither specifically mention nor contemplate the far-fetched argument
now advanced by reform opponents that premium tax credits would only be
available for state-based exchanges.”
As important, elsewhere in the law The Department of
Health and Human Services is ordered to set up an exchange in states
that fail to set up their own. So, in reality, the Federal exchange
acts as a proxy to fulfill the same intentions of the law as occurs in
states that set up their own exchange. In that sense, there was an
inferred intent, explicitly confirmed by the letter, that people would
have the same benefit of the law, regardless of whether they signed up
for Obamacare via a State exchange or the Federal Exchange.
King’s argument is both far fetched and desperate.
The question is whether the Supreme Court will rule based on the stated
intentions of lawmakers or someone whose lawsuit could take healthcare
away from 13 million Americans because the plaintiff in that suit wishes
Obama was never born.
