START OF 2018 OPEN ENROLLMENT PERIOD

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Monday Short Cuts

Well, since King v. Burwell was not announced today, I guess I'll clear out another mess of stuff from my in box (Note: Many of these stories should have their own full entries, but I just don't have time at the moment):

IMPORTANT: The "death spiral" which isn't happening referred to in the link below is the one which Republicans claimed would happen due to the ACA itself. Ironically, if they win King v. Burwell, such a death spiral would almost certainly happen in the 30+ states which aren't running their own exchange.

Not so long ago, critics of Obamacare were warning of death spirals, the risk that too many sick people and not enough healthy ones would sign up for insurance, triggering a cycle of ever higher costs for insurers and steep premium hikes for consumers.

That didn't happen. In fact, a $10 billion cushion that the Affordable Care Act created to protect insurance companies from high-cost patients turned out to be more than needed, the government announced yesterday.

In other words, the death spiral didn't happen as they predicted, so they're making damned sure that it does happen now.

I've already documented many, many times, both the primary casualties (the 6.5 million who'd lose their tax credits and almost certainly their coverage), the secondary casualties (the additional 2 million or so who'd likely lose their coverage due to the massive "death spiral" rate hikes) and the tertiary victims (the additional 4-5 million who'd see 40%+ rate hikes beyond whatever their premiums were set to increase in the first place).

I've also noted a fourth, far less likely consequence: The possibility that the ruling could even be retroactive to 1/1/14, meaning millions of people would get screwed over a third time by having to pay back tax credits they've already received.

This article, however, discusses the negative impact on other parts of the economy if the tax credit spigot is turned off in these states:

As the U.S. Supreme Court prepares to rule on whether people in 34 states can continue to receive Obamacare health insurance subsidies, economists are projecting billions of dollars in lost healthcare spending for hospitals, drugstores and drugmakers if the justices say the payments are illegal.

...Health economists calculate the economic impact of a ruling against the subsidies in different ways, but one thing many agree on is that about two-thirds of people who receive subsidies through HealthCare.gov would drop their insurance altogether rather than foot the entire bill.

Businesses that have benefited from spending by the newly insured would take a hit, though estimates of the lost revenues vary significantly based on which assumptions are built into the calculation.

The past couple of weeks made it seem like Congressional Republicans were finally coalescing around some sort of Ron Johnson/Paul Ryan mashup version of their BS "fix" for King v. Burwell (which wouldn't fix anything and would actually make things even worse). Of course, all of those plans would instantly generate a veto from President Obama.

"Fortunately" (?), it looks like it may not even get to that stage anyway, because...

One of the House’s most conservative lawmakers wants to prevent Congress from rescuing ObamaCare insurance subsidies if the Supreme Court strikes them down this month.

Rep. Paul Gosar (R-Ariz.) rolled out a bill Thursday that would repeal most parts of ObamaCare if the court rules against the government in King v. Burwell.

Unlike recently unveiled plans from House leadership, Gosar’s plan does not include any extension of the subsidies.

That approach was immediately praised by Heritage Action, which has strongly opposed the continuation of the subsidies because they said it will “simply cover up the law’s costs while giving the impression Republicans believe subsidies are necessary for Americans to afford health insurance.”

The group described Gosar's plan as a "conservative response to King v. Burwell."

Over at the National Journal, Caitlin Owens and Dylan Scott have a nice roundup of how the finger-pointing will play out if the Republicans win the case. Unfortunately, it doesn't answer the more relevant question: Who will the voters blame:

It's going to get messy if the Supreme Court rules to invalidate Obamacare's financial aid in more than 30 states that use the federal HealthCare.gov. Everybody will blame everybody else.

Many Hill Republicans will say that it's the White House's fault: Obama and Democrats passed this flawed law, with no GOP votes. They should reap the consequences.

The Obama administration has long said that it can't fix anything in the Affordable Care Act without congressional help. All it would take is a one-sentence bill, which Republicans aren't going to do. Will the GOP really leave millions of Americans on the hook with such an easy solution on the table?

The states seem to be hoping that nobody looks their way, though they too have an answer within their grasp. Wisconsin Gov. Scott Walker exemplified that line of thinking when he said that this was a problem created by Washington—so Washington can deal with it.

Here's your guide to making sense of the spin in King v. Burwell.

More King v. Burwell news: Remember Jonathan "Diarrhea of the Mouth" Gruber? Well, apparently he's back in the news just ahead of the King decision:

The ObamaCare consultant who once mocked the “stupidity of the American voter” had a bigger impact on the healthcare law than previously known, The Wall Street Journal is reporting.

Jonathan Gruber frequently contacted Obama administration officials via email while crafting ObamaCare, according to the newspaper.

The Journal said that previously unreleased messages show that Gruber repeatedly messaged the White House and the Department of Health and Human Services (HHS) between January, 2009 and March, 2010.

He offered advice on healthcare policy and informed officials about media and lawmaker interviews concerning ObamaCare, the report added.

Of course, as Michael Hiltzik noted in response to the WSJ story, it sounds like the Obama administration didn't take Gruber's advice anyway, and he turned out to be dead wrong about at least some key consequences of the law, so while this is certainly kind of embarrassing for the White House and HHS, it doesn't look like it proves much of anything regarding the validity of the King v. Burwell case itself:

In an August 2009 email, Lawrence Summers—then a top economic adviser in the administration—emailed Mr. Gruber and asked “if you were POTUS, what would u do now?” Mr. Gruber responded that Mr. Obama should hold out for enough money to do universal coverage.

He also in April 2009 supplied HHS with information outlining “winners and losers” if employers responded to the law by moving workers into the exchanges.

In a May 2009 email, he said there would be 3.6 million “losers” who were forced into individual coverage after the health care overhaul. “As you might suspect, this group is largely young and healthy,” he wrote. In an August 2009 email, he said 4.2 million people with employer-sponsored insurance would be dropped from having coverage, a development that hasn’t materialized.

Another pretty awkward headline for the Obama administration, although it doesn't sound like it's quite as bad as the headline indicates:

The Obama administration cannot account for nearly $3 billion in subsidies paid to insurance companies in 2014, according to a government watchdog.

Those dollars are untraceable because the Department of Health and Human Services (HHS) did not have “effective” methods to do so, according to a report from the department’s inspector general.

...Meaghan Smith, a spokeswoman for HHS, stressed that the payments are protected by "a number of well-tested controls" to ensure accuracy, as well as the end-of-the-year reconciliation process.

"We are committed to continuing to improve our processes and will work with the Inspector General to implement their recommendations," she wrote in a statement.

Finally, in other healthcare-related news (and speaking of a different "King"), best wishes for a successful procedure and a full and speedy recovery for Senator Angus King:

Sen. Angus King will undergo surgery this week to address a prostate cancer diagnosis he received earlier this year.

The Maine independent said the prostate cancer was detected early, as was skin cancer some 40 years ago from which he fully recovered.

You may recall that Sen. King, an independent from Maine who generally caucuses with the Democrats, gave me a shout-out on FOX News over a year ago, on March 30, 2014, right at the peak of the 2014 Open Enrollment frenzy. In response, I was actually invited to appear on FOX News and I had the honor of telling them to go pound sand. If for no other reason, I have a special fondness in my heart for Sen. King, and wish him a speedy recovery.