Monday's New York Times has a pretty thorough look at just what the "establish an exchange" status is across the various states which would otherwise have millions of people devastated by the impact of the GOP's King v. Burwell court case, which will be decided on either Thursday, Friday or next Monday (most likely Friday now, as I understand it).
They cover the three states which already have a "federally-assisted" state-based exchange (Oregon, Nevada, New Mexico); Hawaii, which is in the process of moving to that status; the two states which are hoping to do so next year (Delaware and Pennsylvania)...as well as the other 32 states which don't have bupkis at the moment.
At first, this article in the Washington Times doesn't look like anything special...it's basically one of dozens of stories about the potential political and real-world impact of the King v. Burwell decision on a specific state...in this case, Oklahoma:
OKLAHOMA CITY (AP) - While the U.S. Supreme Court considers a key case related to the Affordable Care Act, officials in Oklahoma have taken little action to prepare for a ruling that could threaten the tax subsidies nearly 90,000 residents are using to purchase health insurance.
HOWEVER, it's the next couple of paragraphs which made me do a double-take:
Because Oklahoma opted not to create a state exchange where residents could shop for health insurance, Oklahomans instead purchased their plans through a federal exchange, but opponents who are challenging the law, including Oklahoma Attorney General Scott Pruitt, argue the law only allowed for the subsidies through state exchanges.
Note: My estimate for Alaska is actually slightly lower than this (16K), and my estimate of the average tax hike those Alaskans would have to pay is actually half of the amount in the article ($3,200 vs. $6,400), but that's because I'm assuming only the 2nd half of the year's credits would be rescinded:
Robin Barker, a longtime resident of Fairbanks and Bethel, struggled with chronic illnesses for years that kept her from working. Her only option for health insurance cost nearly $800 a month for a policy that came with a $15,000 deductible. Prescriptions alone set her back $12,000 a year.
“Money was just pouring out of our retirement savings,” she said.
...Interviewed at her Fairbanks home as she recovered from a bout with pneumonia, Barker said she was happy to qualify for Medicare but was concerned about Alaskans who won’t be able to afford health coverage if the U.S. Supreme Court strikes down subsidies. If that happens, she says, “families will be destroyed.”
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.
No King v. Burwell Supreme Court decision again today, but most pundits were always expecting it nextMonday, June 29th, anyway.
However, there's a total of 7 cases still left to announce (including Obergefell v. Hodges, aka the same-sex marriage case), so they've also tacked on another extra Opinion announcement day: Thursday the 25th.
I'm not gonna get a damned bit of billable work done this week, am I?
UPDATE: According to CNBC's Dan Mangan, they've added Friday the 26th as well...
At this point, pretty much every healthcare reporter, pundit and especially the healthcare actuaries are pretty much reduced to this:
Welp, it's Monday again, which means it's time to once again huddle in front of my keyboard while anxiously watching SCOTUSblog's Live Blog of the Supreme Court's opinion announcements...
Of course, they might not make the King v. Burwell announcement today, either; it could still be next Monday, the 29th. Or, they could throw in another surprise "bonus" decision day on Thursday. (sigh)...
UPDATE 10:20am: NEVER MIND. No King v. Burwell announcement today.
I think the headline accurately depicts former Texas Governor and current Presidential Candidate Rick "Do The Glasses Make Me Look Smarter?" Perry's defense of the appallingly high uninsured rate in Texas during his 14-year tenure as chief executive of the state.
Perry appeared on FOX News Sunday with Chris Wallace this morning, and for the 2nd week in a row, Wallace actually acted like a Real Journalist® instead of a GOP/FOX hack and pressed Perry with some solid questions regarding the sorry state of healthcare coverage in his state.
Took my wife and 9-year old to see Pixar's latest, Inside Out.
Sheer brilliance. Run-don't-walk to see it, etc. etc.
For anyone who was afraid that they'd lost their touch with Cars 2* (and only partly regained their footing with Brave and Monsters University), I'm thrilled to report that they're back at full throttle here.
That is all.
*(I actually kind of liked Cars 2, but I know most people seemed to hate it.)
