With the high court's help, GOP welcomes healthcare chaos

Jan. 30, 2015, 5:44 PM UTC

By Steve Benen, Steve Benen

Occasionally, congressional Republicans have said American families need not panic about the outcome of the King v. Burwell case at the Supreme Court. Even if the ridiculous far-right argument prevails, GOP officials have said, policymakers will make sure everything works out all right.

The message, for the most part, seemed directed at the Supreme Court justices themselves. "Go ahead and gut the Affordable Care Act," Republicans signaled to the court. "Well make sure the consequences aren't too severe."

The posture was a lie. We're reminded this morning that if GOP justices on the high court are worried about societal effects and the real-world impact of the King v. Burwell case, they should know that Republicans in Congress will welcome chaos, sit back, and watch the American health care system burn.

Congressional Republicans say they won't move to preserve consumers' health insurance tax credits if the Supreme Court strikes them down, raising the stakes in the latest legal challenge to the Affordable Care Act. [...] Leaders in the GOP-controlled House and Senate see the court challenge as their best hope for tearing apart a law they have long opposed. If the court strikes down the subsidies, Democrats are expected to clamor for lawmakers to pass a measure correcting the language in the law to revive them. Congressional Republicans say there is no possibility they would allow that.

Remember, as far as the public is concerned, a clear majority of Americans would expect the Republican Congress to protect consumers from hardship. Indeed, Greg Sargent this week flagged the latest report from the Kaiser Family Foundation, which found that nearly two-thirds of Americans would expect lawmakers to keep existing subsidies in place if the Supreme Court ruling goes the wrong way. Only a fourth of the country would expect Congress to do nothing.

The same report found that even most Republicans support states setting up exchange marketplaces so that families can continue to receive subsidized access to medical care. This is, of course, the exact opposite of what GOP policymakers have in mind.

As for supporters of health care, a Democratic source this morning let me know about a website featuring amicus briefs filed with the Supreme Court in this case. (These "friend of the court" documents are filed by outside parties, with no direct connection to the case, and intended to provide justices with useful, relevant information). Consider what some of the key players are telling the court in the King v. Burwell case:

AARP:

"Reading the ACA to limit premium tax credit eligibility only to people who live in states that operate and Exchange will make insurance unaffordable and inaccessible to millions of low- to moderate-income Americans in the 34 states with Federally Facilitated Exchanges and even to those who do not qualify for the tax credits, will cannibalize the Act's key reforms, and will put countless lives in jeopardy -- results that are plainly contrary to the purpose of the ACA."

American Cancer Society:

"At no point in the legislative process did any of the Amici understand -- or see evidence that any of the legislators or the other participants in the drafting process intended -- that the availability of tax credits and the resulting affordability of health insurance under the ACA would depend on whether a state chose to establish its own health insurance Exchange or have the federal government create an Exchange on the state's behalf. Had our organizations received any indication that this outcome was intended or even contemplated, we would have objected to any suggestion that the health and finances of patients with serious diseases should be made dependent upon the entity administering their state's Exchange. We would have objected even more strongly to any suggestion that patients' lives and health should be used as a bargaining chip to induce states to establish Exchanges themselves, rather than relying on the federal government. Amici did not make any such objections, because we saw no evidence that the issue ever arose during enactment of the ACA."

American Hospital Association:

"We will not mince words: Petitioners' position, if accepted, would be a disaster for millions of lower- and middle-income Americans. The serious financial impacts on hospitals from Petitioners' interpretation are too important for the Court to ignore. At the end of the day, hospitals must be allowed to cover their costs. If they cannot, patients will suffer in the long run."

Catholic Health Association:

"In advancing their mission, Catholic hospitals and Catholic Charities agencies have witnessed firsthand the devastating impact of the lack of affordable health insurance and health care on vulnerable members of our society. The Catholic Health Association therefore advocated for the passage of the Patient Protection and Affordable Care Act (ACA or Act), which expands health care coverage to those without it in all 50 states and decreases the cost to society of providing health care. Subsidies provided by the ACA enable more Americans to obtain health insurance and therefore are integral to the Act's aims. Limiting those subsidies would have a tremendously negative effect on the ministry's mission and millions of low and moderate income Americans who have already benefited from increased access to health care."

This is pretty powerful stuff from non-partisan entities that have no ideological ax to grind. The justices would be wise to take their perspectives seriously, rather than just starting with the GOP's preferred outcome and working backwards to rationalize it.

To be sure, congressional Republicans have been aggressive in sending the justices their own amicus briefs, pleading with them to tear down the system, but we already know with absolute certainty that these GOP briefs include fraudulent claims that Republican lawmakers themselves clearly do not believe.