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Lots of people will lose insurance if SCOTUS takes it away from them

Just a reminder.

It's constitutional - deal with it

It’s constitutional – deal with it

With a U.S. Supreme Court decision looming this month on a point of law that could dismantle the Affordable Care Act, a series of new reports offer a grim glimpse at the toll on Texas should the court decide against the Obama administration.

An estimated 1 million in Texas could lose their health insurance if the high court strikes down a provision in the Affordable Care Act that allows people to get tax subsidies that make their premiums more affordable through the federal insurance exchange, according to a study commissioned by the Texas Association of Community Health Centers and the Texas Academy of Family Physicians.

Those people could soon rejoin the millions in Texas who are already without health care coverage. Texas leads the nation in the number of uninsured with a rate of about 17 percent. Before the implementation of the health care law, the rate was 24.6 percent.

The pain is especially acute in Texas, the report says, because state leaders chose not to expand Medicaid, which left another 1.5 million people who were eligible without coverage.

“This is unconscionable. … What do you tell the million people in Texas who about to lose their coverage? That they didn’t deserve it in the first place?” said Ken Jandra, president and CEO of Community Health Choice, a HMO with 300,000 members is Houston.

[…]

In Texas, 85 percent of those insured through the federal marketplace receive an average tax credit of $247 a month. Without the subsidy, premiums could climb 305 percent, according to a study released last week by the Kaiser Family Foundation.

The most recent figure I saw for Texas was 1.2 million enrollments on the exchange; eighty-five percent of that – the share of folks who have subsidized coverage – yields the one million at risk number. The number of uninsured Texans dropped by eight percentage points this year versus what it was pre-Obamacare. We’re still at twice the national rate because our shortsighted and pound-foolish Republican leadership stubbornly refuses to expand Medicaid, but it’s still big progress. Which can be taken away by the whim of five Supreme Court justices, if they decide to do that. Anyone who thinks either Congress or those same state Republicans will do anything to fix this in that event probably thinks swimming in the bayou during a heavy rain is a good idea. For now at least, all we can do is hope for the best. Kevin Drum, Daily Kos, Better Texas Blog, and KUHF has more.

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9 Comments

  1. Ross says:

    It’s true there might be a negative outcome if SCOTUS rules the plan isn’t legal. However, the process is driven by law, not outcomes. It’s a common Progressive tactic to argue that outcomes ought to trump actual law, when there’s a conflict, but that’s not how our system works.

  2. So, we don’t want good outcomes if there’s some way to make a hyper technical argument against those good outcomes? I must be living in an absurd world. Mark me down as a progressive who prefers good outcomes.

  3. Ross says:

    [email protected], I am all for good outcomes, but not at the expense of the rule of law. ACA is a poorly written hodgepodge of legislative crap that is begging for rejection in many aspects. That’s the fault of the people who wrote it and didn’t pay attention to ensuring that it could withstand the “hyper technical arguments” they knew would be coming.

  4. Ross, if by “rule of law” you mean upholding the spirit and intent of the law as every sane observer saw it at the time it was passed, then I think I agree with you on that point.

  5. Ross says:

    [email protected], the spirit and intent don’t really matter. If the law doesn’t meet constitutional muster, spirit, intent and good outcomes are irrelevant.

    In this case, there is disagreement between two appeals courts that must be resolved. It is entirely possible that SCOTUS will rule that IRS subsidies for people not on a State exchange are permissible, in which case we move on as is. Th eCourt may also decide that the statute says that subsidies can only be paid to people who obtain insurance via a State exchange, and the IRS cannot give tax credits to purchasers who use the Federal exchange. That would be your bad outcome here, but I don’t think it’s a hyper technicality. Both sides have decent arguments, so it’s up to the Supremes. And, again, you can blame the poorly crafted bill for the confusion.

  6. Sorry then. I stand corrected. There really is no way for us to agree. I’m sure you’re right, that right wing BS played no role in the split in the lower courts of appeals. (Eye roll). I don’t agree that both sides have good arguments. I do think it’s a hyper technicality, and I don’t think congressional intent is irrelevant. But I suppose I’ll just have to hold my breath until President Obama calls me up and tells me he’s appointing me to the SCOTUS. (Sorry, I know the “eye roll” parenthetical was a bit much).

  7. Congressional intent seems to have played a big role in the outcome…as it should have.

  8. Ross says:

    [email protected], that’s BS, and you know it. You are more interested in outcome than what the law says. The Supreme Court got this one wrong. The statute says state, not Federal, but apparently words no longer matter, and the plain language of a statute is irrelevant. If Congress intended for the subsidies to be for all, why did they use State?

    The result is fine, but I hate it when courts twist words to mean something other than what they mean.

  9. Jules says:

    The Supreme Court got it right.