GRAHAM-CASSIDY REPEAL BILL DEADLINE:

Time: D H M S

Surreal: Breitbart posts accurate headline, cites ACA Signups as "authoritative" on the subject.

This is the actual headline of an actual article posted on Breitbart.com right now:

I'm loathe to link to the article itself (I did include one somewhere on this page, feel free to look for it), but a Google search will bring it up. Even more remarkably for Breitbart, much of it is actually pretty darned accurate:

Obamacare will go into a death spiral on May 22 if the Trump administration chooses not to continue fighting in court to preserve cost-premium subsidies that were ruled illegal last year.

On May 12, 2016, U.S. District Court Judge Rosemary M. Collyer ruled House v. Burwell that the Obama Administration’s payment of cost-sharing subsidies without congressional approval was a violation of the Constitution’s Appropriations Clause.

The Obama odministration appealed the case to the United States Court of Appeals for the District of Columbia District, where it was renamed House v. Price to reflect the current Secretary of Health and Human Services. Monday, May 22 is the last day for the Trump administration to give notice to the Appellate Court if it wants to continue the appeal.

If Trump drops the appeal and ends the illegal cost-sharing subsidies, Obamacare Silver Plan healthcare premiums will jump by 19 percent. But the national average for Obamacare Silver Plan patient deductibles would also more than quadruple from $709,to $3,064, according to the amicus brief filed by America’s largest hospital groups.

Everything above is pretty much correct. Technically speaking, the exact fallout of this scenario wouldn't be a "death spiral" under a strict definition of the term, but it would amount to the same thing. Also, technically speaking the "death spiral" wouldn't start until either 30 days after the first missed CSR reimbursement payment (most likely end of July if the June payment is missed, I believe) or January 1, 2018. The date depends on whether the carriers end up being able to terminate Silver plan contracts immediately via the "exit clause" baked into them or not, which is the subject of much debate.

What's amazing about this is that it's Breitbart shouting about this from the rooftops, complete with specifically naming Donald Trump as the person to blame if it happens.

The reason completely-in-Trump's-pocket Breitbart is pushing this point is because they assume that most people will pin the blame on Democrats for this issue, since the vague wording in question was, after all, due to some sloppiness in the ACA itself. There's a couple of problems with this logic, however:

  • First: It was the House Republicans who brought the lawsuit. Kind of hard to claim the consequences have nothing to do with you when you're the one who sparked the turmoil in the first place.
  • Second: Every major piece of legislation has glitches which need to be tweaked down the road. If that wasn't the case, the Constitution of the United States itself wouldn't have any Amendments added to it (including the 2nd Amendment which Republicans are so obsessed with).

Social Security had some bugs in it when first passed which were later resolved via bipartisan compromise. Medicare did as well. So did Medicaid. In fact, it was the Democrats who saved Medicare Part D back in 2006 even though they had previously opposed the Republican legislation. Once it became the law of the land, the Dems realized that they had an obligation to help make it work the best they could, so they sucked it up and worked with the GOP to resolve the problems. Result? Medicare Part D is doing just fine these days...except for the "Donut Hole" issue, which was also resolved 4 years later thanks to...the Affordable Care Act. Irony.

Furthermore, unlike the Part D fixes which required quite a bit of work, resolving the CSR issue would be a snap. The House/Senate GOP could resolve it in about 5 minutes by passing a simple amendment formally authorizing the CSR reimbursement payments in question (or by simply dropping the lawsuit, although that may no longer be possible even if they wanted to)...but they won't. It's that simple.

In other words, the GOP is terrified of what would happen if they actually won their case because they know the consequences would be terrifying. Just like with King v. Burwell. Just like with actually repealing the entire ACA ("root & branch," remember?) after 7 years of screaming about how that was the first thing they were going to do once they took power.

As far as I can tell, just like the infamous King v. Burwell case which made it all the way to the Supreme Court before being shot down, the GOP never really expected their case to actually succeed; it was filed as more of a symbolic territory-marking thing than anything. As long as a Democrat was in the White House when the hammer came down, they were fine with that since they could try and pin the blame on the Dems.

The moment Donald Trump was elected President, however, that all got thrown out the window. Suddenly they were in charge of everything, both Congress and the White House. Again, just like the King v. Burwell case, all of a sudden getting what they insisted they wanted (severely damaging the ACA and the individual market alongside it) didn't seem so appealing, so they asked the judge to hold off on giving them their victory for 6 months while they scrambled to figure out what the hell to do to get themselves out of the corner they've painted themselves into.

Here's the really surreal part of the article for me personally, however:

According to the authoritative ACASignups.net blog, that closely follows state healthcare premium increase requests by insurers in each state, Virginia is looking at a 42.6 percent increase; Maryland a 22.6 percent increase; Oregon a 17 percent increase; and Connecticut a 13.9 percent increase.

Yes, that's right: Breitbart.com has declared that I, Charles Gaba, am the authoritative source for healthcare premium increase requests by insurers. A rather odd testimonial to have in my pocket.