You know how all those Texans have been signing up for health insurance via the Healthcare.gov exchange? Every single one of them stands to lose if the Supreme Court decides to play politics.
Nearly 1 million Texans have now signed up for health insurance on the federal marketplace, known as healthcare.gov. But Texas, and 33 other states that did not create their own exchanges, will be the most vulnerable if the U.S. Supreme Court rules against the Obama administration in the latest lawsuit challenging the Affordable Care Act, health policy experts say.
Oral arguments in the case are scheduled for March, and the high court’s decision could come as early as June. If the high court rules that subsidies are not allowed for Texans and others in states without their own exchanges, the ripple effects could be striking. One insurance industry group, in a court brief supporting the subsidies, said eliminating them would trigger a “death spiral” of premium increases and market destabilization.
Without assistance from the federal government, many young and healthy enrollees “are simply going to drop” their health plans, while the sickest people would remain in the market, said Nicholas Bagley, a professor at the University of Michigan Law School. That would expose insurers to greater risk, causing them to hike their rates for all customers, not just those who entered the system through Obamacare plans.
“Holy shit, that’s chaos,” said Robert Laszewski, a health policy consultant in D.C. “What’s ironic here is not only will the Republicans be screwing up the insurance for poor people on the Obamacare exchange, they’ll be screwing up health insurance for rich people in Texas who happen to be in the individual market.”
So far, state leaders have been tight-lipped about what, if anything, they are doing to prepare for a high court ruling. John Greeley, a spokesman for the Texas Department of Insurance, referred questions about King v. Burwell to “state leadership.”
“We’re not gonna weigh in,” he said. As for the state’s decision to create an insurance exchange, he said, “that has not been our call, from the very beginning.”
Representatives for Texas’ largest health insurers also declined to comment.
“Blue Cross and Blue Shield of Texas is waiting for further guidance from the federal government as this situation plays out,” company spokeswoman Margaret Jarvis said in a written statement, though a trade group representing the insurer has written to the Supreme Court in support of the subsidies.
Like I said, a whole lot of Texans are on the chopping block, with a state government that will be happy to let them get sick and die in the name of ideology. (Rep. Chris Turner has filed a bill to establish a state exchange, but – with all due respect – if Rep. John Zerwas couldn’t get anywhere with that, there’s no way a Dem like Turner will.) Having said all that, it’s possible that for all their bluster and BS, the state leadership is quietly hoping for a loss on this one.
States on both side of the issue have filed briefs with the Supreme Court. But only six red states—Oklahoma, Alabama, Georgia, Nebraska, South Carolina, and West Virginia—joined a brief on behalf of the petitioners. Conspicuously missing are deeply conservative states like Texas, with large beneficiary pools, or any swing states under GOP control. Republican senators from many of those states—including Wisconsin, Ohio, and Florida—are in cycle in 2016.
I’ll be honest, it hadn’t occurred to me that Texas hadn’t signed onto this effort. An opportunity to sue the federal government – over the hated Obamacare, no less – and we passed? Did Greg Abbott sleep in the day the other plaintiffs came around looking for amicus briefs? I’m stunned. True, this lawsuit is a steaming pile of baloney with little to no establishment support, but since when has that ever slowed Abbott down? We’ll see how this goes.