David Post: Careful what you wish for on Obamacare
Be careful what you wish for.
You might get it.
House Republicans have voted almost every month for the past four years to repeal Obamcare — over 50 times, costing taxpayers millions, but keeping the flames of discontent burning for election purposes. Ironically, polls show that voters like the Affordable Care Act. They don’t like Obamacare, not knowing it’s the same law.
Now House Republicans are filing multiple lawsuits. At it’s core, the law is about the definition of words. A case now before the Supreme Court is about the word “state.” A lawsuit filed two weeks ago is about constitutional “separation of powers” and the words “2014” and “95 percent.”
Obamacare anticipated the “states” creating a “marketplace” for insurance companies to provide coverage to the insured. The insurance industry supported Obamacare. After all, who doesn’t want 9 million new customers?
When almost half the states didn’t set up marketplaces (for political purposes), the federal government did. Republicans argue that the federal government is not a state making the federal marketplace is illegal. So next spring, the Supreme Court will decide what the word “state” means. To avoid admitting the success of Obamacare in Kentucky, Senator Mitch McConnell (R-Ky.) calls its marketplace “only a website” as if Kentucky would have created it without Obamacare.
If the Supreme Court decides that the federal marketplace is not allowed under Obamacare, millions of insured citizens will suddenly lose their insurance, and costs rise for the rest of us.
Last month, House Republicans filed another lawsuit focusing on the Constitutional separation of powers between the Congress and the president. Congress is responsible for “authorization” and “appropriation” — that is, passing laws and providing money for them. The president is responsible for enforcing the laws.
A key provision of Obamacare provides premium discounts to patients through tax credits. Those tax credits are part of the tax law and are accounted for on tax returns, but Congressional appropriations are not required in the same way that Congress does not appropriate tax dollars for, say, childcare credits or charitable contributions.
Obamacare reimburses insurance companies for those discounts, but Congress has not appropriated the money that is being reimbursed to the insurance companies. The lawsuit says those reimbursements are illegal without Congressional appropriation. In other words, insurance companies are required to provide discounted premiums to low-income taxpayers but cannot be reimbursed.
If Republicans win this lawsuit, insurance companies are going to lose billions, will stop insuring millions, and are likely to increase private health insurance premiums to recover their losses.
Last year, Republicans and large companies complained that Obamacare was happening too quickly and was too hard on large companies. The law imposed large penalties on those that failed to implement those requirements. President Obama granted a one-year extension and reduced the percentage of full-time employee to be covered from 95% to 70%. The corporate community was grateful.
However, Republican now say that adding a year to the implantation date and reducing the percentage of employees required to be covered was a change in the law that only Congress could do. That is like the child who, having killed his parents, seeks mercy from the court because he is an orphan.
If Republicans win, large corporations will pay large tax penalties for being a year late and will have to insure more employees.
Do House Republicans really want to win these lawsuits? Their interpretation of the precise words of the law, regardless of their intent, may have validity.
Obamacare-haters need to be careful what they wish for. They may get it.
David Post lives in Salisbury.