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Saturday, November 8, 2014

Here's to Your Health: So Much for Bipartisanship

The Supreme Court has agreed to hear yet another challenge to the Affordable Care Act.  I'm sure the fact the Supremes agreed to hear this case a mere three days after an election that will return the Senate to Republican control is the purest of coincidence.  The fact that this time, if the justices rule against the ACA, there will be not the slightest shred of a chance that Congress will agree to tweak the legislation to conform to any judicial ruling has, I'm sure, nothing whatsoever to do with their decision to hear the case.  That would indicate crass political calculation, well below the dignity of such an august body of judges.


In case you're interested, at issue as far as I can tell are the semantics of the word "state."  A group of highly indignant folks has taken umbrage with the federal government for providing subsidies to people who cannot afford insurance, when those people live in states that have refused to set up state-run health insurance exchanges.  The dispute revolves around language in the ACA that restricts federal subsidies to those participating in "an exchange established by the state."  The IRS has issued regulations codifying the idea that people may receive subsidies for participating in a health insurance exchange whether that exchange is run by a state or by the federal government, which is running its own exchanges--for the admittedly nefarious purpose of providing health insurance to those whose state governors are only trying to protect them from. . . having health insurance.

One group of federal appeals judges have declared the language in the original legislation ambiguous, and have consequently ruled that the IRS made a reasonable interpretation in establishing its regulations.  Another appeals court has "reluctantly" determined that the law as written does, in fact, forbid the federal government from providing subsidies.  As a liberal, I want to agree with the former, but as a writer, I fear that the second court might actually be correct--or at least is not clearly wrong.  And the larger point is that, while the ambiguity of the phrasing does, in fact, probably give the IRS the right to do what it did, I fear that this same ambiguity will provide the conservative majority on the Supreme Court the political cover it will need to achieve its presumed desire of destroying the Affordable Care Act.  Not that the Court takes into account such crass political calculations.

What everyone should bear in mind is that this law has so far provided millions of people the ability to receive healthcare to which they previously had no access.  Presumably, people are alive today--or at any rate healthier today--because of this legislation.  And for all the talk of gloom and doom and apocalyptic rises in the cost of coverage, nobody seems to be suffering much as a result of the ACA.  Make no mistake, this lawsuit is nothing but the latest mean-spirited attempt to gut a piece of legislation that has as its goal nothing more than to help people, largely out of spite and continued irrational hatred of the man who championed the legislation in the first place.  I just hope the millions of people who lose their coverage if/when the Supreme Court and their Republican enablers have their way will remember this in the next election.

Of course, the GOP will find a way to blame Obama for that, too.

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