Lawsuits, partisanship, and ignorance threaten Obamacare. There is a great deal of confusion over the recent appeals courts' decisions on Obamacare (ACA) in the Halbig suit. At issue is whether the law permits those who got Obamacare through the federal exchanges to get their premiums subsidized by taxpayers to make them affordable.
One three-person panel appeals court dominated by Republicans ruled against the ACA subsidies of federal exchange-issued policies, and the other with more Democrats ruled in support of the subsidies. The administration is appealing the anti-ACA decision to have a ruling of the full bench of justices. The issue could still go to the Supreme Court.
What sort of a reaction could we expect if the Supreme Court rules against Obamacare subsidies? There will not be much impact in Colorado because Colorado and 14 other states set up their own exchanges and can clearly subsidize premiums. Colorado has also expanded Medicaid to the near-poor.
Ten million people would lose their tax credits, and the ACA would be eliminated in 24 states, per the Kaiser Family Foundation, August 4, 2014, Wall Street Journal blog, because they have refused both to expand Medicaid and to set up their own state-run exchanges. Twelve states expanded Medicaid but did not set up state exchanges, so those who signed up through the federal exchanges would lose affordable subsidies.
For those 4.7 million (of a potential total over three years of 9.5 million) who would lose their affordable insurance they already got, the reaction would be an angry one. The Journal of the American Medical Association, July 9, 2014, noted "that 87% of the people signing up for coverage in the federal marketplace qualify for income-based premium subsidies that lower their average premium from $346 per month to $82, a reduction of 76%."
Many would not be angry. About 60% polled recently by the Kaiser Family Foundation (KFF) said they had not been affected by the law, yet the majority still disapprove of the law. Approval of the ACA is about 38%, though approval or disapproval mostly depends on party affiliation. Still 60% did not want it repealed but improved instead.
The ACA's acceptance has been slow because experience with it has been short, and partisanship and ignorance influence public opinion. Per KFF polls, more than 6 out of 10 did not even know or were not sure they had a choice of private plans, the basic feature of the ACA. Nearly 40 percent of enrollees in federal Obamacare exchanges did not even know they were getting federal subsidies.
Those receiving insurance from employers may not realize Obamacare has stopped insurance companies from overcharging (resulting in refunds to consumers), or charging higher premiums for women and setting lifetime caps or that the ACA is responsible for covering cancer screenings without copays. Those advantages will only be fully appreciated and understood when consumers experience them or if the GOP repeals the ACA and takes these benefits away.
A version of this appeared in the Sky Hi Daily News August 22,2014
A version of this appeared in the Sky Hi Daily News August 22,2014
http://kff.org/report-section/survey-of-non-group-health-insurance-enrollees-section-3/
http://online.wsj.com/articles/key-section-of-health-care-law-struck-down-by-appeals-court-1406039685.
http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-july-2014/
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