As King case begins, Ryan, Kline, and Upton offer an important Obamacare alternative | Brookings Institution

March 4, 2015

Just a few weeks after Senate Finance Chairman Orrin Hatch and others unveiled a plan to replace the Affordable Care Act (ACA), or Obamacare, House Ways and Means Chairman Paul Ryan and two other House Republican chairmen have also announced the outlines of a proposal with an accompanying op-ed. Ryan is joined by John Kline, chairman of the Education and Workforce Committee, and Fred Upton, chairman of Energy and Commerce – all key committees when it comes to health care.

As with the Hatch plan, it is important to focus on the core substance of the proposal and not on the “off-ramp” or “repeal” language accompanying Republican plans. Politics and positioning will shape the language of the health debate over the next several months. That’s Washington. But the real question is this: does the Ryan proposal have ingredients that could be part of a future agreement on the long-term shape of the American health care system? I believe it does.

via As King case begins, Ryan, Kline, and Upton offer an important Obamacare alternative | Brookings Institution.


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.


Ryan, Kline, And Upton Unveil More Specifics About Obamacare Supreme Court Contingency Plans

March 3, 2015

Yesterday, three key Republican senators on health care issues published an op-ed in which they outlined the broad principles of how they would address potential outcomes in the big Obamacare Supreme Court case, King v. Burwell. Today, three House Republican leaders—Paul Ryan (Wisc.), John Kline (Minn.), and Fred Upton (Mich.)—unveiled their own plan, with important new details. It’s a significant step forward.

The new op-ed, published in the Wall Street Journal, outlines an “off-ramp from Obamacare” which would transition enrollees in interested states into a better system. The three congressmen chair three House committees with major impact on health care policy: Ways and Means (Ryan), Energy and Commerce (Upton), and Education and the Workforce (Kline). All three were involved in the working group organized by Sen. John Barrasso (Wyo.) and the Republican Policy Committee.

via Ryan, Kline, And Upton Unveil More Specifics About Obamacare Supreme Court Contingency Plans.


Senate Republicans Reveal Their Supreme Court Obamacare Contingency Plan

March 2, 2015

On Sunday night, three Republican senators—Orrin Hatch (Utah), Lamar Alexander (Tenn.), and John Barrasso (Wyo.)—published their plan to address the potential outcome of a Supreme Court in the King v. Burwell case, for which a decision is expected this June. Republicans aim to convince the Supreme Court’s swing justices—particularly John Roberts—that they can rule on the merits of the case, without worrying about how their opinion might affect Obamacare’s participants. Will it work?

via Senate Republicans Reveal Their Supreme Court Obamacare Contingency Plan.


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