6/27/16:In light of the 1-year anniversary of the Supreme Court's King v. Burwell decision...along with the celebration of the Obergefell vs. Hodges decision and today's Whole Woman's Health v. Hellerstedt decision, I've dusted off this post from a year ago...
(THIS IS BEING UPDATED MOMENT TO MOMENT, SO CHECK BACK FREQUENTLY FOR UPDATES)
However, if the courts decide to look at the case on the "micro" level--parsing exact definitions of the word "State" (which seems to be the concensus as to how they're proceeding from the people I've talked to about it), then they'll also have to (or at least certainly should) also look equally closely at two other words: "Establish" and "Facilitate."
So, as I said, depending on how the court defines the terms "establish" (ie, to "establish" an insurance marketplace) and "facilitate" (as in, "facilitating" the purchase of insurance policies through the marketplace), it's conceivable that all it would take for any of the individual states to "establish" their own exchange would be to register a domain name at GoDaddy or wherever and set up a simple welcome/information portal site...which would then lead them to HC.gov for the actual purchase of the policy.
As petty and stupid as this may sound, it's no more petty and stupid than the plaintiff's case in the first place.
But LePage has also tried to take advantage of a wording error with the 2013 law funding energy efficiency programs. While lawmakers wanted $60 million spent to help homemakers use less energy heating their homes, the snafu would have reduced that to $22 million—less than half.
The text error in Maine involved just one word left out—"and." However, it wasn’t just the wording that mattered but also a decision from a body controlled by his appointees, the Maine Public Utility Commission, that ruled 2-1 that there would be far less money for efficiency projects than legislators wanted.
The error came down to this, according to the Portland Press Herald:
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.”
So, for the past few weeks I've been shouting from the rooftops about the other fallout of the King plaintiffs winning: Massive rate hikes next year, which would likely cause a roughly 50% rate hike across 34 states for millions of people.
I based that on the assumption that 2016 rates would already be going up 10-12% on average anyway, plusan additional 35-47%, for a total increase of around 50%. I based this on:
100 x 1.10 x 1.35 = 148.5 (48.5% increase)
100 x 1.12 x 1.47 = 164.64 (64.6% increase)
I decided to be err on the low side of this range, figuring that even a 50% rate hike would be more than enough to make the point.
However, according to a new article by the Urban Institute (the source of the earlier 35% increase estimate...the RAND Corporation was the source of the 47% estimate), it looks like it could be even higher:
Yes, with the All King v. Burwell, All The Time® mindset this month, it's easy to forget that the core purpose of this website is supposed to be to track the enrollment numbers...and between KvB and this being the middle of the off-season, it's no wonder that there hasn't been much of that lately.
With that in mind, thanks to Andrew Sprung for this tidbit...Indiana is one of the states which initially refused to expand Medicaid under the Affordable Care Act, but which came around earlier this year, starting enrollment in their (heavily modified) Medicaid expansion program at the end of January.
"The Healthy Indiana Plan ... is aspirational," said Brian Neale, the governor's health policy director. "We believe that individuals, if offered the opportunity, will make the right choices."
The Kaiser Family Foundation has posted their latest Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces.
The main paragraph which leaps out, of course, is this one:
Across the 11 cities we examined, the premium for the second-lowest-cost silver plan in the Marketplace – before accounting for any tax credit – is increasing by an average of 4.4%. By contrast, in these cities, the average change in the benchmark silver plan was -0.6% from 2014 to 2015. (The nationwide average increase in this plan was 2% from 2014 to 2015).
Reuters reports that Senate Democrats are already preparing to roll out their response if the Supreme Court invalidates Obamacare subsidies for millions in three dozen states:
No. 2 Senate Democrat Dick Durbin said that if the administration loses the case, Democrats would offer a short piece of legislation clearly saying the tax subsidies are also available to people on the federal exchange.
“It’s one sentence and it’s already been written,” Durbin said in a Capitol hallway. “I hope we don’t need it,” Durbin added.
I can add more: According to a Dem leadership source, Democrats already have a one-sentence bill written on both sides — in the House and the Senate — and it will be introduced in both chambers at the “first available opportunity” if the Court ruling requires it.
...This should be an easy choice for opponents of Obamacare. The end of federally subsidized exchanges will be the first step in freeing patients, doctors, and insurers from government control. Unbelievably, however, some are considering legislation to extend the subsidies, should the Supreme Court block them.
A whole mess of people keep asking me (as they do other ACA bloggers/reporters/pundits) how I think the Supreme Court will rule on the King v. Burwell case.
I've gained a lot of acclaim & attention over the past year and a half for making pretty accurate projections for ACA exchange enrollment numbers.
However, when it comes to predicting how the Supreme Court will rule on stuff, I haven't a clue.
Having said that, it seems to be pretty well accepted that the 4 more left-leaning Justices (Ginsburg, Sotomayor, Breyer & Kagan) will almost certainly rule for the federal government, while the 3 hard-right Justices (Scalia, Thomas and Alito) will almost certainly rule for the plaintiffs. That would leave Anthony Kennedy and Chief Justice John Roberts as the "swing votes".
