The GOP’s months-long debate over when and how to send a repeal of Obamacare to the president’s desk now appears to have an answer.
They can’t do it all at once.
Repealing the law “root and branch” is probably out of the question, the chamber’s parliamentarian is hinting, because some parts of Obamacare don’t affect the federal budget. That’s a must in order to use the obscure procedure known in Senate parlance as reconciliation, which allows lawmakers to avoid the 60-vote filibuster hurdle and pass bills on a simple majority vote.
That’s not the GOP’s only problem. Under those rules any Obamacare repeal has to reduce — not increase — the deficit. So Republicans will have to pick and choose which parts of the Affordable Care Act they most want to ditch.
A sweeping measure to offer state-subsidized healthcare coverage to people in the country illegally was significantly pared back Thursday in an effort to rein in costs as it cleared a key legislative hurdle.
Rather than extend Medi-Cal--California's healthcare coverage for the poor--to all eligible adults regardless of immigration status, as originally proposed, the amended bill by state Sen. Ricardo Lara would set up a limited enrollment healthcare program.
The board of Connecticut’s health insurance exchange approved a 22 percent hike in the fee it charges insurers to help fund its operations, a cost that’s likely to be passed on to insurance customers.
The fourth post, written in response to an interview he did with my colleague Harold Pollack over at healthinsurance.org, was a bit more forgiving, but still brought out my nasty snark.
WILLIAMSON: Where have you been, Shelly? Bruce and Harriet Nyborg?? Do you want to see the memos...? They're nuts... they used to call in every week. When I was with Webb. And we were selling Arizona...they're nuts...did you see how they were living? How can you delude yourself??
LEVENE: I've got the check...
WILLIAMSON: Forget it. Frame it. It's worthless.
LEVENE: The check is no good?
WILLIAMSON: You stick around; I'll pull the memo. I'm busy now.
LEVENE: Wait a minute...their check's no good? They're nuts...?
WILLIAMSON: You wanna call the bank, Shelly? I called them. I called them four months ago when we first got the lead. (pause) The people are insane. (pause) They just like talking...to salesmen.
In 2014, the overall average premium payment rate for those who selected a Qualified Health Plan (QHP) from the various ACA exchanges ended up being around 88% nationally. This varied from state to state and company to company, but in the end it was roughly 88%.
In 2014, the overall average net monthly attrition rate ended up being roughly 3% per month (by net, I mean after taking into account both new people enrolling during the off-season and existing enrollees dropping their coverage). Based on this, here's what the 2014 exchange enrollment looked like (click image for full-size version):
The whole fuss and bother at the heart of the King v. Burwell case centers around this subsection of the Patient Protection and Affordable Care Act:
(2) (a) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer's spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311 [1] of the Patient Protection and Affordable Care Act
The short version of the plaintiff's argument, of course, is that supposedly this means that federal tax credits are kosher for individual states which "established" their ownexchanges (16 states plus the District of Columbia) but not for the remaining 34 states, since they're being run by the federally-"established" exchange.
The government's defense, of course, is that there's like a half-dozen other places throughout the law which make it pretty damned clear that tax credits should be kosher for states run through the federal exchange as well:
Every once in awhile I'm accused of being a little too blunt. As a blogger, I'm presumably not under the same "professional standards" of language and protocol as, say, the New York Times, the Associated Press or the U.S. Congress.
That's why it came as quite a relief to me to read this quote from an AP story in the New York Times this morning, which sums up the Republican Party's quandary pretty succinctly:
"If you win the case you actually have people who lost their insurance. You now share the responsibility for fixing it," said former Rep. Tom Davis, R-Va., who once led the House GOP campaign committee. "And you've got a lot of pissed off people. That hurts you."
Actually, the main angle of the AP story is that the King v. Burwell case has supposedly now turned into the old Life Cereal TV commercial. You know the one:
Whenever I post about King v. Burwell, I have a tendency to lump all 34 states together into collective numbers (around 6.5 million losing their tax credits, plus another couple million being priced out of the market due to the resulting premium spikes, plus another 4-5 million having to pay through the nose to keep theirs).
Next, I assume my standard 88% payment rate. Ironically, the higher this percentage is, the more people who could actually get royally shafted by a King plaintiff win.
NOTE I posted a partial version of this entry last night, then yanked it overnight in order to think about whether it was a valid concern or simply the same sort of click-bait headline hysteria that I've criticized other sites for posting.
After thinking it through, I"ve decided to go ahead and post a modified version with a bit of additional context and a less panicky headline. Think of it as more of a legal thinking exercise than anything else...but at this point, anything is conceivable.
For months now, I and many others have been sounding the warning bells re. the absurd King v. Burwell ACA case, currently awaiting a decision by the Supreme Court.
