Friday, January 31, 2014

George Will Explains Why Obamacare Will Triumph, by Saying It's Doomed


George Will thinks he's found a way to wreck Obamacare and throw millions off their
health insurance. Here he's pictured calling his conscience and getting no answer.

Okay, I haven't completely thought this through or found corroborating opinion, but when George Will revealed in his latest op-ed why Obamacare was doomed by its very own language, I drew a completely different conclusion.

In a nutshell, Will said that the PPACA's own language contained a poison pill that the IRS conveniently misinterpreted in order to let the Act proceed:
The four words that threaten disaster for the ACA say the subsidies shall be available to persons who purchase health insurance in an exchange “established by the state.” But 34 states have chosen not to establish exchanges.
So the IRS, which is charged with enforcing the ACA, has ridden to the rescue of Barack Obama’s pride and joy. Taking time off from writing regulations to restrict the political speech of Obama’s critics, the IRS has said, with its breezy indifference to legality, that subsidies shall also be dispensed to those who purchase insurance through federal exchanges the government has established in those 34 states. Pruitt is challenging the IRS in the U.S. District Court for the Eastern District of Oklahoma, and there are similar challenges in Indiana, Virginia and Washington, D.C.
Now, I've read his column, and I've read the National Journal that explains why the Pruitt lawsuit has problems but that it doesn't mean it can't prevail before a conservative Supreme Court discovering it's got another Bush v. Gore moment on its hands. (in Bush v. Gore the Court famously said here's our ruling, but it's not a precedent! It's a one-time freebie for W.!) A Court that can do that can do anything, literally.

I'm not worried. First, the case might not prevail, and Obamacare lives on in its current form. But actually, Pruitt could prevail, and the Supreme Court could effectively dictate that subsidies can't be offered in the states that don't run their own exchanges. George Will expects this outcome and high-fives his heartlessness in advance. Good on ya, George.

But, second, that's not as good an outcome as Georgie boy thinks it is. Imagine this scenario: Subsidies are then denied in the 34 states that opted not to set up their own exchanges. Those that did, however, get to keep the subsidies and the many of their citizens who finally could afford insurance get to keep their subsidized insurance.

What do the 34 states that lose the subsidies do after the ruling? Will there be dancing in the streets, with throngs of people singing "ding dong, Obamacare is dead!" and commuters honking their horns and complete strangers high-fiving each other on kissing in the town square like it was V-J Day all over again?

No, that won't happen. Many states will cry "Hey, we want what California, New York, Kentucky, Washington, etc. have! No fair!" That's what will happen, and one by one Republican governors and Republican state legislatures are going to be dragged kicking and screaming into passing laws to build their own exchanges.

That's what will happen. And, as Martha Stewart used to say, it's a good thing.

Sorry, George. If the ruling goes the way you hope it will, Obamacare will not be scrapped, it'll be strengthened and HealthCare.gov will shrink almost over night. Either that, or an awful lot of Republican politicians are going to be out of work.

Note. There is another possible scenario, I have to admit: The states without subsidies -- many of which also didn't accept the Medicaid expansion -- will slowly, each after the other, craft health-insurances bills of their own that work either better or worse than Obamacare. Then, as they notice problems in their new healthcare systems, they'll tweak their laws to fix them. Slowly, things get better. Still, the whole process will probably weaken the Republican hold on state legislatures and state houses.

There is one other scenario, and that's that Congress hastens to fix the wording problem. Don't hold your breath on that one.

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