Moyers: Republicans May Finally Get Their Wish to Watch the Affordable Care Act Destroyed

[Triana]

On Friday, the Supreme Court agreed to hear the case of King v. Burwell, perhaps the last gasp in the Republican attempt to use the courts to destroy the Affordable Care Act. The reaction to this news among liberals was, to put it mildly, shock and dismay. Simply put, the lawsuit is a joke, and the fact that any judge, let alone a justice of the Supreme Court (not to mention five of them) would do anything but laugh it out of court is a testament to just how shamelessly partisan Republican judges have become. At least four justices have to consent to hear a case, so it’s possible that there will still be five votes to turn back this stink bomb of a case. That will probably depend on the good will of John Roberts, something I wouldn’t exactly want to stake my life on. But lives are indeed at stake.

There are a couple of optimistic scenarios for how this could all turn out, and I’ll explain why I suspect they’re wrong. But in case you haven’t been following, this case rests on what is essentially a typo in the ACA, where it refers in one spot to subsidies provided to Americans in health insurance exchanges “established by the state.” The conservative activists who brought the suit contend that these three words prove that Congress did not intend subsidies to be available in states that declined to set up their own exchange and therefore defaulted to the federal exchange. (There are 36 such states.) They manage to argue this with a straight face — or perhaps a cruel smirk might be a better description — despite the fact that every member of Congress, congressional aide, journalist and everyone else who was there at the time agrees that no one ever contemplated the insane idea that Americans in states using the federal exchange would be ineligible for subsidies.

According to the Department of Health and Human Services, eight million Americans got private insurance through all the exchanges in their first open enrollment period, and 5.4 million of those were in the federal exchange. Of those, 86 percent, or 4.7 million, received subsidies to make their insurance affordable. If this lawsuit is successful, those millions would all lose their subsidies. Many, if not most, would probably be unable to purchase insurance and would rejoin the ranks of the uninsured. Then premiums for the remaining people in the exchanges would skyrocket, insurers would drop out and the result would be a death spiral that not only destroys the exchange altogether but also undermines, perhaps fatally, the other two legs of the “three-legged stool” that comprises the ACA: the requirement that insurers accept all customers regardless of pre-existing conditions, and the individual mandate. (If you’d like details on how this would happen, you can read this amicus brief filed by 49 distinguished economists who study health care.)

This is, of course, just what the conservatives wish for. The purpose of their campaign is to destroy the Affordable Care Act; the swath of human misery, stretching from horizon to horizon, to be left in that campaign’s wake is precisely the point. Among all the acts of cynicism and deception that this debate has featured in the last five years, this lawsuit must surely rank near the top for its sheer villainy.

THE REST:

http://billmoyers.com/2014/11/12/republicans-may-finally-get-wish-watch-affordable-care-act-destroyed/

[randys1]

1. If Roberts flips back, he and the other 5 justices will be guilty of mass murder

[Warpy]

3. That's the problem with rigid ideologues

They don't give a shit how many people their ideology kills.

They're the biggest mass murderers in history, whether religious or political.

[sadoldgirl]

2. Is this the reason why

Roberts allowed the ACA to pass? I wonder.

If the SCOTUS ruins the ACA, what will the Repugs replace it with? They always claimed
that "system" was better. Which "system"?

[YOHABLO]

4. If SCOTUS does knock it back .. do you think people will hit the streets in protest .. that would be

a good thing. So let it roll Repugs .. let's see how far you get with this. Drums of rebellion are thumping

[Brigid]

9. Rebellion? Really?

Only if the Khardasians go off the air.

[Maedhros]

5. The repeal of the ACA could have a silver lining,

in that actual health care reform might be attempted at some point in the future. Could make 2016 a fight for single payer, and we would win that fight.

[CANDO]

6. I'm with you on this

This really wasn't health care reform. It was insurance company entrenchment. Most people who buy the shitty insurance plans will still not be able to afford to use the insurance. It's not insurance if you can't afford to use it(premiums+deductibles+coinsurance). It's a fucking scam of historic proportions. I have insurance through my employer and it's a scam. In my opinion, if you have to pay for premiums and deductibles and then coinsurance, then it isn't insurance. It's a fucking money stream from your bank account into that of insurance companies.

[Yo_Mama_Been_Loggin]

10. And then unicorns may breed and multiply

How far in the future are you talking about? Years? More like decades.

[Skeowes28]

7. Reform it

Hold the gop faucks accountable it will stay

[Rstrstx]

8. In the end I don't think 'Established by the State' will matter much if at all

I think the Supreme Court is going to ignore the trivial language the plaintiffs have brought up and will go back their original ACA decision to uphold the mandate but strike down the medicaid expansion.

When they struck down the medicaid mandate they referenced a case called Pennhurst State School & Hospital v Halderman as part of its reasoning that it was unconstitutional. Pennhurst deals with how Congress doles out money to states and, in this case, how explicit Congress needs to be when establishing conditions on such money. Some excerpts used from Pennhurst were cited in NFIB v Sibelius by Roberts in his medicaid decision. Among them:

&quot t)he legitimacy of Congress’s exercise of the spending power “thus rests on whether the State voluntarily and knowingly accepts the terms of the ‘contract"

&quot a)s we have explained, “though Congress’ power to legislate under the spending power is broad, it does not include surprising participating States with postacceptance or ‘retroactive’ conditions.” Pennhurst, supra, at 25. A State could hardly anticipate that Congress’s reservation of the right to “alter” or “amend” the Medicaid program included the power to transform it so dramatically"

Note this is not exactly the same case as we have here but the idea is similar: the states need to know what they're getting into before they decide whether to accept or reject something. This argument is further strengthened in Pennhurst, though not cited by Roberts:

Turning to Congress' power to legislate pursuant to the spending power, our cases have long recognized that Congress may fix the terms on which it shall disburse federal money to the States.... Unlike legislation enacted under § 5, however, legislation enacted pursuant to the spending power is much in the nature of a contract: in return for federal funds, the States agree to comply with federally imposed conditions. The legitimacy of Congress' power to legislate under the spending power thus rests on whether the State voluntarily and knowingly accepts the terms of the "contract."... There can, of course, be no knowing acceptance if a State is unaware of the conditions or is unable to ascertain what is expected of it. Accordingly, if Congress intends to impose a condition on the grant of federal moneys, it must do so unambiguously. By insisting that Congress speak with a clear voice, we enable the States to exercise their choice knowingly, cognizant of the consequences of their participation.

These are arguments vastly more persuasive and convincing rather than the semantics of how to read the simple words "Established by the State". If Congress had indeed intended to limit tax credits exclusively to exchanges enacted by the states previous case law would suggest Congress would have had to have gone much beyond a simple four word blurb. The only argument you could make against this is that the tax credits are going to individuals in a state rather than the state itself, but considering that money given to a state is intended to be used for its residents in the first place I think that's a pretty weak argument to make and I have a hunch this is the reason the court may have taken this case, fearing the appellate courts weren't seeing the forest for the trees.

[Skeowes28]

11. Reform it

Hold the gop faucks accountable it will stay