Dear Republicans, Please Do Not Save Obamacare

March 3, 2015

Of course, there’s little chance Democrats would help pass Sasses’ 18-month plan. More likely, they will unite behind a plan that subsidizes those in states without contrived Obamacare “marketplaces” in perpetuity. Obama would not. Who knows who the next president will be? If Republican governors take whatever ensuing payoff is offered by the administration, they would either pay a price politically or not. The GOP should not be the one offering it.

If Obamacare crumbles, there will be immense political pressure on both sides. Democrats will continue to argue that a failure to give something to Americans is the equivalent of taking something away from them.  And at some point conservative have to come up with compelling rejoinder to this argument.  They can do it now, or later. What they shouldn’t do is make the Democrats’ arguments for them.

via Dear Republicans, Please Do Not Save Obamacare.


King v. Burwell: 4 words and 8 million Americans – AEI

March 3, 2015

Administration supporters argue that the plaintiffs are ignoring the whole text of the ACA and focusing on four words — “established by the State” — in isolation. But the disputed ACA section 1421 authorizes subsidies for enrollees “through an Exchange established by the State under section 1311” (emphasis added), the section that directs states to establish health exchanges. Federal exchanges are authorized for states that fail to establish an exchange under a different section, 1321, which is conspicuously absent from section 1421. The IRS rule would only make sense if section 1421 provided subsidies for exchanges established under section 1311 and 1321 or if it specified exchanges established by the state and federal governments. Congress could have easily inserted such language.

Opponents of the lawsuit claim no reputable legal scholar takes the plaintiffs’ legal arguments seriously (the New York Times called them “baloney”). Yet, in two of the three challenges to the IRS regulation decided thus far, federal courts have sided with the King plaintiffs. Only the Fourth Circuit in King v. Burwell has disagreed and the court conceded it was a close question because the statutory language is ambiguous.

via King v. Burwell: 4 words and 8 million Americans – AEI.


A Post-King Bridge to Somewhere Better | Economics21

March 3, 2015

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.

via A Post-King Bridge to Somewhere Better | Economics21.


Republicans Shouldnt Try to Save Obamacare Subsidies in Wake of King Ruling

March 3, 2015

Eliminating the subsidies nationwide would therefore cut Americans’ tax liability by approximately $48 billion on net. Granted, these sums from CBO apply to all 50 states, while the King ruling would apply only to the 37 states that have not established exchanges. But the trend from the numbers is crystal clear: The tax reduction from eliminating the employer mandate, and weakening the individual mandate, outweighs any tax increase from eliminating the subsidies — meaning a favorable ruling in King v. Burwell would cut Americans’ taxes by many billions.

via Republicans Shouldnt Try to Save Obamacare Subsidies in Wake of King Ruling.


The Plain Text of ObamaCare – WSJ

March 3, 2015

Then in 2012 the Internal Revenue Service simply declared that subsidies would be available in both the state-run and federal exchanges. In its rule-making the IRS noted that “commentators disagreed on whether the language . . . limits the availability of the premium tax credit only to taxpayers who enroll in qualified health plans on State Exchanges,” conceding the controversy but offering no legal justification for nationwide subsidies.

In King, the High Court will scrutinize this IRS decree using the traditional canons of statutory construction. The English language is clear: Congress wrote that subsidies would be available on state exchanges only, so Washington cannot deputize itself as the 51st state—especially when the black-letter law is as consistent, tightly worded and cross-referenced as the Affordable Care Act.

To take one example, the Secretary of Health and Human Services was empowered to grant unlimited sums of money to states to establish exchanges. But the law appropriated not a penny for the federal exchanges, and HHS raided internal slush funds to build them. If there is no legal difference between the federal and state exchanges, why did HHS need this budget ruse?

via The Plain Text of ObamaCare – WSJ.


Paul Ryan, John Kline and Fred Upton: An Off-Ramp From ObamaCare – WSJ

March 3, 2015

Any state that uses our off-ramp would be able to opt out of ObamaCare’s insurance mandates. These coverage requirements are driving up costs, so eliminating them would empower individuals and families to choose from a wider range of plans that fit their personal needs and budgets. Our proposal will also allow participating states to opt out of ObamaCare’s burdensome individual and employer mandates, allowing Americans to purchase the coverage they want.

We would also force insurers to compete for your business, rather than force Americans to buy a government-approved health plan under the threat of IRS fines. Let people buy insurance across state lines. Stop frivolous lawsuits by enacting medical-liability reform. Let small businesses band together so they get a fair deal from insurance companies. Our committees and nonpartisan analysts alike estimate that these proposals will cut costs and raise quality across the board.

via Paul Ryan, John Kline and Fred Upton: An Off-Ramp From ObamaCare – WSJ.


A Polarized Court, Weighing a Reversal of the Safety Net – NYTimes.com

March 3, 2015

When I asked historians if they could think of any similar undoing of an existing part of the social safety net, several said they could not. The court blocked parts of President Franklin D. Roosevelt’s New Deal, but never dismantled such a large program already underway. The best-known piece of health care law to be repealed by Congress — a 1988 law expanding catastrophic coverage in Medicare — was far narrower than the Affordable Care Act. It was also only starting to go into effect when Congress undid it, in 1989.

Julian Zelizer, a Princeton historian and the author of a new book on the 1960s expansion of the safety net, said the closest analogy might be Reconstruction and the reaction to it. An enormous federal effort initially succeeded in expanding civil rights in the South, only to be reversed in later years. The reversal lasted decades.

via A Polarized Court, Weighing a Reversal of the Safety Net – NYTimes.com.


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