What would a reasonable compromise look like, after a few weeks of posturing, buck-passing, and finger pointing? (1) Limiting these new rules to just those states that have not established ACA-compliant exchanges. (2) Holding harmless for the rest of 2015 current federal exchange enrollees who were taken hostage with illegal taxpayer subsidies, but not adding new victims.
Whether the new pathway for subsidized coverage flows more directly through state governments (such as through a capped appropriation or block grant mechanism based on the levels of exchange subsidies for a given state in the first half of 2015) or a modified and less complicated federal tax credit mechanism is less important. If the two key, unpopular, and unwise mandates of Obamacare are ended going forward in about three-dozen states, the road to replace, revise, or repeal will be in sight, along with a brighter future for more affordable, accessible, and sustainable health care.
In the interim, the insurance market sky will not fall. Practicing politicians will not get their first, or maybe even their second, choices, but they will agree to a workable compromise. Not because many of them want to, but because they will have to do so.