Wednesday Night Short Cuts

Trying (once again) to get these off the books ahead of tomorrow's Supreme Court Opinion Announcements (although most people seem to think that King v. Burwell will be announced on either Friday (most likely) or Monday)...

Cathy Barney remembers well the days her family budget was overwhelmed with a nearly $1,200 monthly bill for health insurance.

...The Milford family of four finally got the break they’d been pleading for two years ago. Under key provisions of the Patient Protection and Affordable Care Act, the Barneys now pay just $400 a month for their health insurance thanks to cost-saving tax credits ushered in by President Barack Obama’s long debated health reform law, also dubbed Obamacare.

“We finally got some relief,” said Barney. “It’s been nice to not have been so squeezed these last two years.”

But all of that could change in the next week.

Undocumented immigrants provided a surplus of $35.1 billion to the Medicare Trust Fund between 2000 and 2011, according to a new Journal of General Internal Medicine study recently published. The findings challenge concerns that undocumented immigrants are financially burdening the health care system.

According to the study, undocumented immigrants contributed $2.2 and $3.8 billion more than they withdrew annually between 2000 and 2011 to a Medicare program known as the Hospital Insurance Trust fund. The total contribution of their surplus was $35.1 billion.

We can start with a simple, commonsense improvement: making sure that mothers are given every opportunity to offer their babies a healthy start. That means offering women the opportunity to sign up for health insurance the moment that they find out they're pregnant, getting the prenatal care they need.

Right now, events like the birth or adoption of a child, marriage, divorce, or even moving to a new state all trigger a special, 60-day window allowing individuals to enroll in a new health insurance plan. Yet pregnancy, one of the most life altering events anyone can experience, isn't included on that list.

Many believe our politicians won't let it come to that. (Though the Supremes are ostensibly above such considerations, New York's Jonathan Chait saysChief Justice John Roberts will not "spend down his political capital to land a temporary, partial blow against Obamacare.") Here's an overview of the various scenarios that may play out if the Supreme Court deals a new blow to Obamacare.

"The chaos that would be created by a court ruling for the challengers doesn't spill over across state lines," said Larry Levitt, a senior vice president at the Menlo Park-based Kaiser Family Foundation.

But that doesn't mean the Golden State's exchange, called Covered California, doesn't face other significant challenges, from trying to build up its enrollment numbers, to the end of federal revenue guarantees for health insurance companies that agree to participate in the exchange -- something observers say could cause premiums to spike.

WASHINGTON — Congressman Mo Brooks (R-AL5) announced Tuesday evening his support of a bill that would allow individuals to deduct the amount spent on health insurance from their taxable incomes, potentially saving taxpayers thousands each year.

H.R. 2812, the Tax Free Health Insurance Act, would create a deduction for “premiums for insurance which constitutes medical care.”

According to the Centers for Medicare & Medicaid Services (CMS), in 2013 there were 20.9 million Americans who purchased individual health insurance for themselves and their families, and none of these individuals were able to deduct this cost from their taxes.

Currently almost all businesses are able to deduct their health insurance costs for their portion of the premium paid.

Wisconsin Gov. Scott Walker issued a threat to the Obama administration on Wednesday that if the Supreme Court rules against healthcare subsidies, states will not take steps to save the law.

“Governors across the country have been clear: If the Supreme Court strikes down the Obama executive overreach, we will not bail out Obama at the expense of the American people,” Walker wrote in an op-ed for CNN.com on Wednesday.

The looming court case, which Walker called “a turning point” for the law, could come as early as Thursday. If the administration loses, 6.4 million people could lose their financial aid under ObamaCare because they don’t live in the dozen or so states that run their own healthcare exchanges.

Walker has already said that he would not set up a state exchange, even if it means that 200,000 people in his state would no longer receive subsidies — which he acknowledges is “a big problem.”

Some states are grappling with higher insurance costs for consumers while others are seeing record-low requests for premium increases in 2016 because of the Affordable Care Act, state insurance commissioners told Congress Wednesday.

Most Americans want the Supreme Court to side with the government when it decides whether the feds can continue subsidizing insurance premiums in all 50 states under President Barack Obama’s health care law, according to polls in recent months.

But few have a lot of confidence that the court can rule objectively in the case, King v. Burwell.

Five things to know about public opinion on the Supreme Court’s coming decision on the health care law:

It’s a decision that could play havoc with the Affordable Care Act.

But Oregon is trying to sidestep the problem.

Rep. Mitch Greenlick, D-Portland, said Oregon’s Legislature dealt with King v. Burwell when it wrote a new law transferring Cover Oregon to the feds.

“We designed it with very careful advice from our attorneys to make certain that as a federally supported state exchange, our citizens would be covered regardless of which way King v. Burwell would come out,” he said.

Whether Oregon’s efforts are successful, depend largely on the court’s decision. But a few other states including Delaware, Nevada and New Mexico are trying similar side steps.

The court could issue a stay, which would delay when the ruling takes effect, but it is not clear how long that would need to be to give states adequate time to react. This is not a question of a few extra days or weeks.

Unfortunately, that is not the only timing problem for states. A decision is expected at the end of June, but the 2015 legislative session closes on or before June 30 2015 in the majority of states. Only eight of the legislatures in the states using the federal exchange have the authority to continue to meet after June 30, let alone to introduce and enact new legislation and put it into operation before the start of the next open enrollment period on November 1 2015.

In the other 26 states, calling a special session – a rare event in any context – is fraught with political complication.

Worse yet, the legislatures in at least four states – Texas, Nevada, Montana and North Dakota – only sit in odd-numbered years. So any legislation creating exchanges in response to Burwell in those states is unlikely to move forward until at least 2017.

If the Supreme Court strikes down Obamacare subsidies in two-thirds of the country, President Barack Obama won't be the only leader offering to assist states that want to undo the damage.

Officials in states that created their own health insurance exchanges under the Affordable Care Act -- thereby shielding their residents from the possible consequences of the lawsuit currently pending before the high court -- are standing by to help their counterparts in other states get marketplaces up and running that would allow subsidies in those states to flow again.

Dallas County property owners paid more than $467million in taxes last year to Parkland Health and Hospital System, the county’s only public hospital, to provide medical care to the poor and uninsured.

Their tax burden likely would have been lower if the state of Texas had elected to expand Medicaid, the federal-state health insurance program for low-income people. If more low-income patients at Parkland had been covered by Medicaid, then federal and state taxpayers would have picked up more of the costs.

If you want a taste of how confusing the political fallout of King v. Burwell will be if the Supreme Court knocks out some of the subsidies available under the Affordable Care Act, Wisconsin Gov. Scott Walker has you covered. In the run-up the court’s imminent decision, the likely 2016 contender is threatening to cut off Obamacare benefits in his state while boasting how he’s used the same benefits to reduce the uninsured.