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“GOP Bad Faith Legal Mischief”: Democrats Have Every Reason To Save Republicans From An Obamacare “Bloodletting”

Sometime this month, possibly as early as Monday morning, the Supreme Court will issue its ruling in King v. Burwell. If the Court ignores both the text and purpose of the Affordable Care Act, and rules for the challengers, millions of the law’s beneficiaries in 34 states will quickly lose their insurance subsidies and be forced off their health plans. The ensuing chaos would be the consequence not just of the ruling itself, but also of the Republican Party’s expected unwillingness to pass a one-sentence bill clarifying that Obamacare subsidies are available in every state, whether or not each state established its own health insurance exchange.

When King, and similar cases, were first conceived, they quickly became vessels of hope for conservatives, who recognized how difficult and punishing it would be to hobble or eliminate Obamacare through the legislative process. What many of them have come to recognize in the subsequent years is that farming out the job to the judiciary can’t spare them from the subsequent political cost: As decision day approaches, more and more of these conservatives are acknowledging candidly—and typically anonymously—that they will suffer badly if the Supreme Court does the very thing they’ve asked the Supreme Court to do.

“The most likely option is that Congress is unable to pass a fix,” an anonymous Republican Hill staffer told Joel Gehrke of the conservative National Review—a magazine that has beseeched the Court to void the subsidies. “Either Republicans won’t be able to settle on a fix or the president will veto whatever we do come up with. At that point, it will be up to the governors to pass their own laws deeming the national exchange a state exchange. That is the path of least resistance.”

Gehrke looks at the cross-pressures Republicans would face after a ruling for King and wonders whether they “could be in for a bloodletting.” Though they can’t admit it publicly, the promise of a bloodletting—compounded by the fact that every vulnerable Republican senator in cycle next year represents an affected state—is precisely why so many Republicans privately hope the Court will uphold the subsidies.

If the conventional wisdom which took shape after oral arguments—and to which I subscribe—is correct, the government will win, and this painful exercise in bad faith legal mischief will come to nothing. But if the challengers win, and a bloodletting ensues, Democrats won’t be able to stand back while Republicans absorb the political damage. Bloodletting or no, Obamacare will be crippled in most states. It could easily remain crippled indefinitely. Its fate will turn on the question of whether the political consequences for Republicans resemble the consequences of a government shutdown or collision with the debt limit. But either way Democrats will have to play an active role in bringing about a resolution.

The best-case scenario for Democrats is a public outcry so severe and sustained that Republicans cave, and agree to restore the subsidies with a clean fix.

Republicans have tacitly acknowledged that they won’t be able to sit on their hands while state insurance markets collapse. They have introduced legislation in both the House and Senate that would restore subsidies, but only for existing beneficiaries, and only on conditions Democrats could never accept, like the repeal of the ACA’s individual mandate.

You can interpret these offers in two ways. The first, as Greg Sargent of The Washington Post has noted, is that these bills are designed to be vetoed, allowing Republicans to blame an uncompromising Obama for perpetuating the crisis. But they could also serve as bases for a compromise, or surrender. If the public responds to a ruling for King the way they’ve responded to other GOP-instigated crises, Republicans would have to scale back their demands and eventually agree to reinstate the subsidies, perhaps for a modest price.

Two different forces will push in that direction. Even if sprinkled liberally with poison pills, and even if its proximate purpose is to invite a veto, Republican-sponsored legislation to partially reinstate ACA subsidies probably can’t pass. Democrats aren’t going to vote for an ersatz fix and neither will many rank-and-file conservative members of Congress. “As soon as the messaging is out there saying, ‘Look, a half-a-sentence fix saves millions of people from either losing their coverage or having massive spikes,’ we as a party won’t be able to sustain that pressure very long — certainly not through the August recess,” another Republican aide tells Gehrke.

But that doesn’t mean Democrats will win a standoff outright. Though their case for a clean fix will be compelling, they will also be highly motivated to reinstate the subsidies immediately, even if it means Republicans get to pocket unreciprocated concessions. Those can’t include structural damage to the core of the law, but could include eliminating things like the medical device tax and the employer mandate.

Real danger arises if, per Gehrke’s other source, an adverse King ruling registers somewhere below a government shutdown on the political Richter scale, inflicting damage on the GOP but not enough to make them seek a solution in earnest. Against the backdrop of a paralyzed Congress, Obamacare would begin to unravel in dozens of states, and would continue to do so until at least 2017. A ruling for the challengers would boomerang violently on Republicans, but Democrats have every reason in the world to want them spared from it.

 

By: Brian Beutler, Senior Editor, The New Republic, June 8, 2015

June 13, 2015 Posted by | Affordable Care Act, Democrats, King v Burwell, Republicans | , , , , , , | 1 Comment

“Some GOPers Want To Play Chicken”: Getting An Obamacare Repeal Bill On Obama’s Desk; For What?

There’s an interesting Rachel Bade/Jennifer Haberkorn piece up at Politico about all the trouble congressional Republicans have encountered in trying to use the budget reconciliation process to pass a simple veto-proof “root and branch” repeal of the Affordable Care Act. Seems the Senate parliamentarian is telling them they’d have to limit themselves to items with an immediate budgetary impact in any reconciliation bill. But any “partial” repeal–much less a replacement–legislation would raise policy questions on which Republicans disagree, and might also involve deficit-boosting consequences for which offsets would have to be found. So some GOPers want to play chicken:

Some conservatives and staff in both chambers, like House Freedom Caucus Chairman Jim Jordan (R-Ohio), are urging the chambers to do a straight one- or two-sentence repeal of everything. They argue that the parliamentarian has to look only at the words in front of her during reconciliation and should not be able to force lawmakers to break out the provisions on their own.

One aide working on the matter suggested they may try this and see if it works — but others are doubtful.

I guess I’m unclear as to why this is worth the trouble. Getting legislation repealing Obamacare onto Obama’s desk, long the obsessive goal of congressional Republicans, will not accomplish a thing other than confirming that Obama doesn’t want to kill his signature domestic policy achievement and Republicans do. I think most voters out there for whom opposition to Obamacare is a “bullet vote” have probably already figured out they should vote Republican in 2016. So the whole exercise appears to be one of those “energize the base” things whose value I am always questioning.

I do think that if SCOTUS kills Obamacare subsidies in states using federal exchanges there will be some value in Republicans getting a bogus “fix” onto the president’s desk in order to blame him for the subsequent chaos. In that contingency they could almost certainly structure a bill that would meet the conditions for reconciliation, and could probably tamp down any internal opposition by ensuring dissenters there’s zero chance any of it will become law. But on “root and branch repeal,” they might as well just promise they’ll git er done when President Bush or Walker or Rubio takes office.

 

By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, June 1, 2015

June 5, 2015 Posted by | Affordable Care Act, Budget Reconcilation, GOP | , , , , , , , | 1 Comment

“The Political Consequences?: Will Republicans Suffer Politically If The Supreme Court Strikes Down ObamaCare? Don’t Count On It

Next month, the Supreme Court might rule in King v. Burwell that the Affordable Care Act does not make subsidies available on insurance exchanges established by the federal government. In a rational world, this argument would be laughed out of court, as even former Republican politicians and congressional staffers have suggested. But that’s not the world we live in.

So it’s worth considering the political fallout if the Supreme Court’s Republican nominees throw the U.S.’s health care market into chaos. The short answer is that, with some notable exceptions, Republicans could very well get away with it.

The policy consequences of such a ruling are much clearer: It would be a disaster. Without subsidies, the vast majority of people would not be able to afford insurance, and therefore would not be subject to the mandate to carry insurance. As a result, younger and healthier people would drop out of the insurance market, creating an actuarial death spiral in which more and more expensive policies are offered to fewer and fewer customers — until the exchanges collapse. Millions of people stand to lose their insurance as a result.

This, of course, is why Congress did make subsidies available on the federally established exchanges. It certainly didn’t go to the trouble of creating a federal backstop that was designed to fail. And until a few libertarian fanatics willfully misread the law as a Hail Mary in their legal war on the ACA, nobody on either side of the aisle involved in the bill thought otherwise.

Should Republicans be careful what they wish for? Possibly. “Fear of change has been the right’s most powerful weapon in the health-care wars since they began under Harry Truman,” writes New York‘s Jonathan Chait. “Seeing their weapon turned against them is a frightening sensation, one they are likely to experience many times again.” The GOP “might be better off if the court just left the law as is,” agrees The Washington Post‘s Greg Sargent. Even The Wall Street Journal editorial page is worried.

The idea that destroying ObamaCare would be politically counterproductive is superficially plausible. Any such decision would be a 5-4 opinion with only Republican-nominated judges in the majority, over at least one lengthy dissent. The Republican-controlled Congress could restore the subsidies by passing a one-paragraph bill, as President Obama will surely emphasize repeatedly.

Congress could try to pass the buck to Obama by passing a “fix” loaded with poison pills that the president would have to veto, but I agree with Chait and Sargent that the Republican conference is too dysfunctional to pull this off. And when Congress fails to act, overwhelmingly Republican-controlled statehouses could solve the problem by establishing their own exchanges — could, but in most cases won’t.

So a Republican Supreme Court takes health insurance away from millions of people, and Republican-controlled governments fail to take simple steps to solve the problem. That has to be a political disaster for the GOP, right?

Not necessarily. “If the Obama Administration loses in the Supreme Court,” argues New Yorker legal analyst Jeffrey Toobin, “the political pain will fall almost exclusively on the president and his party.” And counterintuitive as it might seem, political science favors Toobin.

The problem is that a separation-of-powers system dilutes accountability, and voters generally lack the information that will allow them to sort out the blame for a given disaster. Presidents generally get both more credit and more blame for what happens under their watch than is justified by their power.

This is reflected in the fact that the ACA — a statute that required immense congressional skill on the part of Democrats to pass — is commonly known as ObamaCare. To voters who aren’t Democratic partisans, Republican assertions that Obama is at fault for any bad outcomes that arise from ObamaCare will carry a lot of weight. The media, which tends to give credence to even hare-brained Republican notions out of a misguided effort to remain balanced, is unlikely to make it much clearer.

It may also seem as if Republicans would take the rap for a decision written by a bare majority of Republican-nominated justices, but this overlooks how little the public knows about the Supreme Court. Only a little more than a quarter of the public can name the chief justice. The vast majority of voters will have no idea whether the decision was 5-4 or unanimous, let alone the partisan details of the split. Justice Ruth Bader Ginsburg might write her greatest dissent, but it’s hard to imagine it changing many minds, given that only a tiny minority reads Supreme Court opinions and almost all of them know what they think about the case beforehand.

So in general, I do think Toobin is right. Republicans in Congress and in deep red states can probably avoid any consequences. But there is one twist. Republicans are most vulnerable in states with federally established exchanges that are led by the GOP, but tend to swing to the Democrats in presidential elections. Voters in those states are more likely to blame Republicans for not establishing a state exchange.

As it happens, one such state is Wisconsin, whose governor is a frontrunner for the Republican nomination in 2016. The Republican primary electorate will prevent Scott Walker from signing a bill establishing a state exchange, but his refusal will make it harder for the GOP to duck the issue. In this instance, it might be harder for Republicans to deflect responsibility to Obama than it would be otherwise.

Ultimately, the political consequences of a Supreme Court ruling against the government are difficult to predict. But what we know for sure is that it would be best for the Supreme Court to uphold ObamaCare — so we don’t have to find out.

 

By: Scott Lemieux, The Week, May 27, 2015

May 30, 2015 Posted by | Affordable Care Act, King v Burwell, Republicans | , , , , , , , | 2 Comments

“Shocking Sloppiness Won’t Doom The Health Reforms”: Republican Politicians Will Have A Lot Of Angry People On Their Hands

How many politicians, aides, lobbyists, lawyers, insurance moguls, professional groups, and interns — both the political and medical kind — agonized over the details in the Affordable Care Act? The number is big.

But despite thousands of hands in the kitchen, the final product included four words that cast doubt on a cornerstone of the reforms — subsidies for those buying coverage on federal health insurance exchanges. Unbelievable.

Diehard foes of the reforms have weaponized those words as a means to kill the law. They argue in the Supreme Court case King v. Burwell that specifically offering subsidies for plans bought on exchanges “established by the state” means no help for those going to federal exchanges.

Since the program started, low- and middle-income Americans have been receiving tax credits for coverage on both types of exchanges. Almost everyone assumes that’s how it’s supposed to be.Take away subsidies for federal exchanges and only the sickly will join it. The economic structure underpinning guaranteed coverage will collapse as premiums charged for plans on federal exchanges soar and the healthy stay away in droves.

The plaintiffs, though they come from the right, are doing their Republican colleagues no favors. You see, when the Affordable Care Act created federal exchanges in states that had not set up their own, leaders in Republican-controlled states could noisily defy President Obama while taking few political risks. They could refuse to set up state exchanges knowing that their constituents would enjoy subsidized coverage on the federal exchanges.

Lose those subsidies and Republican politicians are going to have a lot of angry people on their hands. Some 7.5 million Americans receive subsidies on federal exchanges.

Hypocrisy now crashes over the Republicans’ wall of opposition to the Affordable Care Act. Politicians are currently rewriting the story of their obstruction of a law that they dread could come apart.

An exasperating example is Olympia Snowe, a former senator from Maine who fancies herself a moderate Republican. During the battle for the bill’s passage, she strung Obama along for months, pretending that she might provide him at least one Republican vote. (Why Obama indulged these stalling tactics… perhaps his memoirs will tell.)

Anyway, Snowe recently commented that the little words at the heart of the Supreme Court case were unintended. “Why would we have wanted to deny people subsidies?” she said. “It was not their fault if their state did not set up an exchange.”

So why did she vote against the bill? She also railed against “Obamacare” as a “government-run health care system,” not that this was the case. Until Snowe left the Senate in 2013, she worked with her party to undercut the reforms.

But get this: At the time of the bill’s writing, Snowe proposed letting Americans buy cheaper drugs from Canada. It was OK, apparently, for a foreign government to help struggling Mainers obtain health care, but not OK for their own to do so.

One expects the health reforms to survive this latest assault. The best outcome would be the Supreme Court’s confirming that the words were a mistake and that yes, subsidies for the federal health exchange are legal.

If the court says no, politicians in states relying on federal exchanges could swing into action and set up some form of state exchange. And the Obama administration would probably make it easy for them.

The bipartisan takeaway here is the appalling state of American governance. We now hear from all sides that omission of subsidies for the federal exchanges was “sloppy,” “careless,” “inadvertent,” “a drafting error.” Actually, it was inexcusable.

But let’s move on.

 

By: Froma Harrop, Featured Post, The National Memo, May 28, 2015

 

 

 

May 29, 2015 Posted by | Affordable Care Act, Health Exchanges, King v Burwell | , , , , , , | 1 Comment

“The Right’s Collective Amnesia And Fantasia”: Former Republican Senator Admits The Obamacare Court Challenge Is Built On Lies

For months, when the Affordable Care Act was still swimming upstream through the legislative process, President Barack Obama and Senate Democrats courted Senator Olympia Snowe, a Republican from Maine, thinking she would respond rationally to enticements and provide Democrats bipartisan cover to reform the U.S. health insurance system.

Their efforts ultimately failed. Snowe, like every other Senate Republican, voted against the health reform bill in 2009 and 2010, and then joined Republicans in their various efforts to undermine or repeal the law, until she retired in 2013.

But now it looks like all the time Democrats wasted on negotiating with Snowe, and allowing her to help shape the legislation, has paid off. Snowe has, to my knowledge, become the first contemporaneous Republican senator, current or former, to acknowledge that a Supreme Court challenge meant to cripple Obamacare is built on a tissue of lies. If the Court sides with Obamacare opponents, her comments will become incredibly relevant to the ensuing political shitstorm.

“I don’t ever recall any distinction between federal and state exchanges in terms of the availability of subsidies,” Snowe admitted, according to New York Times health reporter Robert Pear.

“It was never part of our conversations at any point,” said Ms. Snowe, who voted against the final version of the Senate bill. “Why would we have wanted to deny people subsidies? It was not their fault if their state did not set up an exchange.” The four words, she said, were perhaps “inadvertent language,” adding, “I don’t know how else to explain it.”

There are two intersecting argumentative threads that one must untangle to really understand King v. Burwell. The first, specialized one addresses the question of what the text of the Obamacare statute means. Does it, in all its interlocking, cross-referenced parts, provide authorization for the IRS to issue subsidies to all exchanges? Or does it prohibit those subsidies in the three dozen states that have availed themselves of federal fallback exchanges, through Healthcare.gov? Only the most cribbed reading of the law—literally less than a sentence of the whole text—suggests the latter.

The second thread is, if anything, even more straightforward: What were the framers of the Affordable Care Act trying to do? Were they trying to stitch together a harmonious system across all state borders, with subsidies available everywhere? Or were they trying to coerce states into setting up their own exchanges by threatening to withhold subsidies from their citizens, and impose chaos on their insurance marketplaces? There is no evidence to suggest that the goal of the Affordable Care Act was the latter.

These threads invariably become entwined for two reasons. First, if Congress was trying to create an incentive for states to set up their own exchanges, then its failure to provide those states clear notice of the threat in the law raises serious constitutional concerns. But also, judges have consciences and intellectual standards, too, and may in some cases allow their understanding of the political history of the Affordable Care Act to influence the way they think about what the text of the law actually conveys. This explains why conservatives have been engaged in a year-long campaign to revise the history, and assert that the framers of the ACA knew all along that threatening the states would leave the law vulnerable to ruin, but did it anyway.

Pear’s article largely elides the textual question—if anything, it proceeds from the assumption that Obamacare opponents have a better legal case than they really do. But at the same time, it is devastating to the spin that Republicans are putting on the ACA’s history to bolster the plaintiffs in King.

Here, for instance, is Snowe’s erstwhile colleague, Senator Orrin Hatch, who served with Snowe on the committee that drafted Obamacare, claiming that the law’s drafters, not its enemies, are falsifying the historical record to influence judges.

“The Democrats were arguing that the only way to get the states to sign up is to put the pressure on them by making them have to do a state exchange, so it’s kind of disingenuous for them to come in now and say they didn’t mean that,” Hatch told reporter Todd Zwillich in this DecodeDC feature. “I’m not the only one that knows that. Their attitude was, you’ll never get all the states to sign up if you don’t force them. Yeah, I don’t think there’s any doubt in the Democrats’ minds they wanted to do that because they were afraid the states wouldn’t form their own exchanges. Now they’re trying to say they didn’t say that, but they did.”

With respect to King, almost every Republican member of Congress is, like Hatch, caught in the grip of the right’s collective amnesia and fantasia. The spectacle of it is breathtaking to sentient observers of the health reform process, but ultimately meaningless if the Supreme Court does the right thing in June, and rules for the government. If it doesn’t, the textual argument will effectively be over. But, for the purposes of reading such a bad decision into its proper context, addressing the ensuing chaos, and clarifying for the record for the public, the historical argument will take on even greater significance—which makes Snowe’s contribution extremely valuable.

 

By: Brian Beutler, Senior Editor, The New Republic, may 27, 2015

May 28, 2015 Posted by | Affordable Care Act, Health Exchanges, Olympia Snowe | , , , , , , | 1 Comment

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