Before the end of the month, the Supreme Court will rule on whether or not an error in the text of the law will outweigh the clear intent of the framers of the ACA. At least that’s how it looks to lots of observers including me.
A different perspective is offered by former GOP Rep Cynthia Davis who believes that “the US Supreme Court is about to announce its OPINION on whether the national government can subsidize medical insurance for people living in states that did not meet the criteria in the Obamacare law.” The eccentric capitalization, by the way, is Davis’ own – I think she wants to show her contempt for the opining of the SCOTUS. She goes on to say that ” If the Court rules that all citizens of all states can get the money, they would be inventing rules in the law that don’t exist.”
This would be interesting if the Supreme Court decision didn’t hinge on whether or not a single drafting error should be interpreted literally or whether the intent – an intent that has been attested to by many even many Republican congresspersons – should prevail. So the issue is, contrary to Davis’ belief, whether a drafting error can actually be interpreted as an actual criteria of the law.
Davis really shows her colors, however, when. after correctly pointing out the disastrous situation that would ensue should King vs. Burwell be decided in favor of the plaintiffs, she concludes:
Without the government “making up the difference”, the harsh economics of regulations and mandates will inflate premiums beyond what would be a reasonable value or appealing to most consumers. Those who actually need medical services would realize their insurance premiums and medical expenses were more tolerable and the charity care was more available before Obamacare.
Really? All of us, even lots of Republicans, knew that the old status quo was unsustainable. Before the ACA insurance costs were escalating so rapidly that more and more of us could not afford to purchase coverage. Even those of us with employer based coverage were being hit with expensive cost-sharing and out-of-pocket costs that escalated,sometimes massively, on a yearly basis. Folks with pre-existing conditions were just flat out of luck. Post-ACA, Premiums are increasing at a much slower rate than before, and millions more Americans have coverage.
As for charity care? Does Davis mean emergency room care or care in charity hospitals? Nether solution has ever been adequate. Emergency room care was heavily subsidized by the federal government and ended up costing us al because it is inefficient and costly to provide care when people have reached the point where they can go to an emergency room.
Charity in general as an alternative to insuracne is an equally silly proposition. Physician and financial planner Carolyn McClanahan writes in Forbes Magazine:
If we had to depend on charity to take care of the uninsured, how much would we need? To provide coverage for the 50 million uninsured people in our country, based on our latest OECD rate of $7,960 per year, we would need about $398 billion. For charity to fund this, we would have to stop all other charitable pursuits, plus increase our charitable donations by another $108 billion per year.
Let’s say we create a wonderfully efficient health care system, and only need the OECD average of $3,233 per year to take care of all the uninsured. The need would now go down to $162 billion. This is over half of what we give to charity now. Do you think any of these other worthy causes would be willing to give up their charitable dollars in the name of helping the uninsured? Many charities asked the Supreme Court to uphold the health care law. They know charity is not the answer.
Sorry Cynthia, the idea that those who might have to navigate the expensive chaos that will result if Republicans finally get their way and take away their subsidies should have to beg charities to take care of them not only stinks, but it is unworkable. And returning to the bad old days before the ACA could only appeal, as the song says, to “them thats got” and don’t give a tinker’s damn about those don’t.
A Missouri lawmaker quoted today in the St. Louis Post-Dispatch shows us the real mindset behind all the GOP efforts to squelch the healthcare law:
Sen. Rob Schaaf, R-St. Joseph, a physician, sponsored that law [i.e., a law prohibiting the creation of an health care exchange in Missouri]. In an interview Tuesday, he said he would not be in favor of creating a state exchange if the subsidies are struck down.
“It is not the place of government to redistribute wealth and that’s all these subsidies are,” he said. According to the most recent federal statistics, about 200,000 Missourians receive an average monthly subsidy of $278 per month to purchase coverage.
Ever hear a better, more self-righteous articulation of the I-got-mine-screw-you mindset? These are the same folks who take money from rich donors in exchange for making sure that if there’s any redistribution of wealth it goes upwards rather than down. Looking at Schaaf’s bio, I notices that he went to public high school and public college. No redistribution there. Nosiree.