2018 MIDTERM ELECTION

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What impact will today's SCOTUS announcement have on #OE2 enrollments?

The Healthcare Twittersphere is all abuzz today with the surprising news that the Supreme Court has agreed to take up the King vs. Burwell case regarding Affordable Care Act tax credits for people who enroll thorugh the federal exchange (Healthcare.Gov). (The King case is sort of the kid brother to the Halbig vs. Burwell case, but they're essentially about the same issue).

All sorts of people on both sides of the issue who are much smarter than I about the legal aspects of this case are furiously posting their take on what's likely to happen after the SCOTUS issues their ruling, which I understand wouldn't happen until sometime next summer (they've agreed to take up the case, but I don't think they start hearing arguments for a few months, and then they bop it around for awhile before issuing their final ruling).

Until now, the only real contribution I've had to make on the topic is my own "worst case" scenario: My "Grand Slam Breakfast" solution which I posted in early July (and which has since been taken pretty seriously by various Very Smart People® such as James Harvey (project lead for the DC exchange), Nicholas Bagley (U of M law professor), Abagail Moncreiff (Boston U law professor) & Joey Fishkin (U of Texas law professor).

Anyway, that's all in the future. Today, I'd like to look at a more immediate question: What impact will today's news have on enrollment during #OE2 (the 2nd open enrollment period) which starts next week?

There are three possibilities:

  • Negative: People who were otherwise inclined to go ahead and sign up via Healthcare.Gov hear something in the news about "Obamacare in danger from another lawsuit" and get scared off, not wanting to be "involved" with something that "may be Unconstitutional" etc, etc.
    Result: Depressed enrollments for #OE2.
  • Positive: People who were otherwise not inclined to "get in on this Obamacare thing" are jolted into action to jump all over it while they have the chance, figuring that even if it does get shut down, they'll at least get 6 months to a year of decent, affordable healthcare coverage before SCOTUS pulls the plug.
    Result: Spiked enrollments for #OE2
  • Neutral: People who aren't paying attention (ie, about 95% of the public on either side of the issue) hear "bla, bla, bla, Republicans attacking Obamacare again, bla, bla, bla, White House defending Obamacare again, bla, bla, bla" and pretty much tune out the whole thing.
    Result: No significant impact on #OE2 enrollments one way or the other.

In addition, there's the question of what impact the news will have on the state-run exchanges, which aren't at risk from King/Halbig being upheld at all (that is, unless the law itself ends up being seriously changed as a result of the ruling). Some state exchanges have already been posting disclaimers/issuing press releases to let their residents know that Halbig/King don't impact them, but lots of people barely understand what the relationship between the ACA and the state exchanges is in the first place, much less what all this "tax credit/subsidy" business is about (even if they're receiving it). Hell, 90% of those still uninsured don't seem to even be aware that #OE2 is coming up at all.

As for myself, I'm still digesting this news. I honestly figured that the SCOTUS would either refuse to take the case outright or that if they did so, they wouldn't make that decision until #OE2 was well underway (or even completed already). This development--yes, they're taking it, announced a week before #OE2 starts--was a bit unexpected. I've been planning on posting my personal prediction for #OE2 QHP enrollment early next week, and there's a lot of factors I have to take into consideration...but I didn't think that this would be one of them.

Thoughts welcome.