Recent Articles

Reuters reported recently that, “Despite the promise of coverage through the U.S. Affordable Care Act (ACA), the number of people applying for non-compliant, short-term health insurance policies was up more than 100 percent in 2014.”

It’s true – more people than ever before are buying short-term, limited coverage health insurance.

But one part of the Reuters report was wrong: the word “despite.”

Senior Republicans who are worried they’ll be blamed for killing health insurance for millions of Americans have been busy assembling a range of options if the Supreme Court strikes down the law’s subsidies in 34 states.
But the GOP senators running for president — starting but not ending with firebrand Ted Cruz — threaten to stymie their leaders’ carefully hatched plans. Any whiff that the GOP’s Plan B is a continuation of Obamacare is bound to spark furious protests from the conservative base, putting pressure on the presidential hopefuls to respond. Cruz, for one, would press for a wholesale repeal of the law — or to allow states to opt out of Obamacare — if the high court provides the opening.

Broken Promises: President Obama recently claimed that ObamaCare is working even better than anticipated. That would be a tough sell to all those hospitals that thought the law would help them make ends meet.
In the Supreme Court’s ObamaCare ruling in 2012, which upheld the individual mandate, the justices also ruled that ObamaCare couldn’t force states to expand Medicaid by threatening all their Medicaid funds if they refused.

Last week, the White House released a report outlining the economic benefits to states of expanding Medicaid. The report continues a line of argument the Obama administration has used in encouraging states to expand Medicaid under the Affordable Care Act, the president’s health-care law.
The administration faces several obstacles in attempting to sell this argument to reluctant states.

Regardless of how the U.S. Supreme Court decides King v. Burwell — a case regarding the Obama administration’s issuance of health insurance subsidies in violation of their own law — the negative consequences for patients and taxpayers will continue absent thoughtful, patient-centered reform.

Later this month, the Supreme Court will likely announce its decision on King v. Burwell, the lawsuit which asserts tax credits currently being paid to health insurers in 34 to 37 states that use the federal health insurance exchange are illegal. If the Supreme Court stops these tax credits, over six million people will be required to pay the full premiums for their Obamacare policies. This will cause a crisis, which will demand a response by Congress and the president.

King v. Burwell and three other cases before the Supreme Court concern whether individuals purchasing health insurance under the Affordable Care Act in states with no state insurance exchange should receive subsidies from the federal government.
If the Supreme Court overturns the subsidies, Congress will be under pressure to protect Americans who signed up for coverage on the assumption that it would be subsidized from the cost increases associated with this withdrawal of the federal funds.
Congress should enact a short-term subsidy plan to ease the transition and solve the problems created under the ACA by granting states the ability to opt into a better approach to reform.

“I just love nuns generally. I’m just saying.” – President Obama, June 9.
And nuns just love him too. At least nuns who run hospitals seem to. And with good reason: the President advocates policies that enable hospitals like those operated by the Daughters of Charity to provide less charity.

This article will assess the legality of executive actions that the Administration may take after King v. Burwell to continue paying subsidies in these thirty-four states. I will not discuss the merits of the case, predict how the Court should construe the statute or IRS rule, or propose congressional modifications to the ACA. Rather, this analysis is premised on potential administrative fixes HHS could employ following an adverse ruling in King v. Burwell.

We’ve famously been told that the Department of Health & Human Services has no Plan B. But what if the Supreme Court forces the executive branch’s hand? Yes, there’ll be plenty of finger-pointing and demagoguery as a high-stakes game of chicken unfolds among the White House, Congress, and various state governments. But what could Obama/HHS do? Remember, this is the president who has a pen and a phone, and “if Congress won’t act, I will.”

The running joke is that HHS/IRS will simply promulgate another rule deeming all federal exchanges to be state exchanges. But that couldn’t possibly be the answer, could it?