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The SCOTUS and the ACA

The Supreme Court made an interesting announcement. They will hear King v Burwell, a suit that challenges a key feature of the Affordable Care Act. The court doesn’t do this kind of thing every day — where “this kind of thing” is to preempt the usual legal chain. King v Burwell was to have been heard en banc by a Federal appeals court but the Supremes cut that off. It takes a minimum of four justices to do this and there’s speculation about which four — most of it focusing on the “usual suspects” who come out of the woodwork whenever there’s a chance to block progressive legislation.

In short, that Scalia et al. see a way to eviscerate Obamacare.

King v Burwell focuses on whether the tax credits that the feds give to help low-income folks buy insurance are expressly allowed within the language of the Act. The suit argues that only the states can provide them and only though state-run exchanges. If the court supports this claim, the ACA will effectively die because every red state will refuse to provide such subsidies — just like they have already refused to participate in the Medicaid programs, an act, as noted before, of reckless stupidity.

Anyway, this is speculation and we’ll have to wait and see how it turns out. The real question is why are they doing this? Why are suits like this being brought? Why is the SCOTUS taking unusual moves like preempting an appeals court?

When you step back and look, long view, it’s a puzzle. Some might argue that the ACA violates basic conservative principles because it contributes to “big government.” But the ACA isn’t “socialized” medicine. Unlike the systems most industrialized countries have, it preserves the role of the private sector. Insurance coverage is supplied by private companies. Most of the hospitals are privately owned. The health care providers are private individuals. The pharmaceutical corporations remain untouched, their profits ever-growing.

Others have tried to argue that it’s too expensive. But this is simply not true. The longer the ACA is in place the greater the savings are seen to be. More people are insured so there’s less pressure on municipal hospitals’ ER’s. Insurance rates are plummeting because more healthy people who need fewer services are insured. Medical costs are coming down because more people are getting preventive care. The ACA is a big, long-term money saver.

Still others argue that it’s unpopular, that Americans don’t want it. There’s something to this but mainly because of the barrage of invective conservatives have unleashed. The longer the ACA is in place the more it’s impact is appreciated. In fact, the rush to undo it is driven largely by fears on the right that, like Medicare and Social Security, everyone will eventually see what a good thing the ACA actually is.

In short, there is absolutely no sane reason for objecting to Obamacare — except for that name in the label that’s been attached to it. It’s HIS signature piece of legislation. It’s the primary reason he will go down in history alongside of others like FDR and LBJ who carved out significant federal programs that made life better for Americans.

That, they cannot bear and that, they will do anything possible to prevent even if it means fucking over the millions of Americans whose quality of life has been dramatically improved by this act. And, since they haven’t been able to repeal it, since their efforts to derail it at the state level are slowly losing steam, since they haven’t been able to defund it, they’re going to a polarized Supreme court and appeal to the Gang of Five to screw America once more.

Fasten your seatbelts. The lingering hope is that Roberts has the wisdom to see further down the road than the others — as he did the last time the wackjobs on the right tried this gambit.

An interesting wrinkle on this case was in The New Yorker recently by James Surowiecki. The point he  makes is that, if the Republicans win this one, it will backfire big time on the anti-anything-Obama crowd. As he notes, it will have zero impact on the main features of the ACA. Everyone will still have to have health care coverage, insurance companies will still not be able to deny coverage based on pre-existing conditions, children up to 27 can still be on their parents’ plans and all those (mostly Blue) states with in-house insurance exchanges will still have cheap plans, subsidized for low-income individuals and famlies.

Who will get hosed? Why the very folks who’ve brought this suit.

In their fervor to undo Obamacare they will be hoist on the their own petard. Suddenly everyone living in those (very Red) states without exchanges won’t have subsidized policies, won’t have tax breaks and, of course, if they are really poor, they’ll be without Medicaid support because those states have refused to take that option as well.

Stupidity shall reap its own rewards. It is sad.

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