IE 11 is not supported. For an optimal experience visit our site on another browser.

ACA foes start to give away the game

Two heavy hitters in Republican politics this week undermined their own party's arguments against "Obamacare."
An Affordable Healthcare Act supporter (R) talks with a student (L) about the law on the campus of Santa Monica City College in Santa Monica, California, October 10, 2013.
An Affordable Healthcare Act supporter (R) talks with a student (L) about the law on the campus of Santa Monica City College in Santa Monica, California, October 10, 2013.
On the House floor yesterday, Rep. Paul Ryan (R-Wis.) delivered a lengthy complaint about the Affordable Care Act, insisting that "proponents of the Obamacare law" are confused. "The problem is reality," the congressman said. "Look what's actually happening in the real world."
That's a good idea -- looking in the real world points to a health care law that's succeeding even beyond the expectations of optimistic supporters. Why Ryan doesn't know any of this is a mystery.
This week, though, some of the Republican rhetoric about the ACA was odd, and some of it was genuinely important. Take, for example, Sen. John Cornyn's (R-Texas) comments yesterday to Roll Call.

Cornyn predicted the King v. Burwell case that will be argued before the Supreme Court in March will end up going a long way towards undoing the law. The court will decide whether the law allows people participating in the federally run health care exchange to get subsidies. A decision denying the subsidies would significantly undermine the law. "What I expect is that the Supreme Court is going to render a body blow to Obamacare from which I don't think it will ever recover," Cornyn said.

Right off the bat, note how bizarre it is to see an elected American official celebrate the very idea of millions of families losing access to medical care.
But just as important is this ongoing perception that Republican lawmakers have begun to look at Republican justices on the Supreme Court as governing partners. In recent generations, GOP officials decried anything that even hinted as "judicial activism," but those principles have been consciously and deliberately trashed -- today's Republicans see the high court as a political backstop, willing to ignore precedent to reject Democratic ideas.
Arguably even more striking still are the recent remarks from Wisconsin Gov. Scott Walker (R).
Ian Millhiser had a doozy of a report this week, noting the Republican governor did an interview with the Wall Street Journal in 2013, which directly contradicts the basis for the pending Supreme Court case.

The Affordable Care Act gives states a choice: they can either set up an exchange where consumers can buy subsidized insurance plans or they can elect to have the federal government set up this exchange for them. Consumers with income below a certain level qualify for tax credits to help them afford this insurance. A case called King v. Burwell, however, asks the justices to cut off these tax credits in states with federally-run exchanges.... The plaintiffs' premise in King is that Obamacare was never intended to offer credits to people in states with federally-run exchanges. Indeed, by reading one passage of the Affordable Care Act out of context, they claim that the law unambiguously states that only state-run exchanges are allowed to provide tax credits. But that's not the conclusion Walker reached after spending a couple of years considering the question.

On the contrary, the Wisconsin Republican -- a likely 2016 presidential candidate -- said he did extensive research and concluded, "[I]n the end, there's no real substantive difference between a federal exchange, or a state exchange, or the in between, the hybrid, the partnership."
Why is this important? Because Walker unwittingly gave away the game -- the whole point of the pending litigation is that the law was designed to entice states to create exchanges, knowing that failure to do so would mean no subsidies for their state's consumers. Here was Walker saying the exact opposite -- he studied how to proceed with the law in Wisconsin and determined there was no practical difference between the federal and state exchanges.
To my mind, this is far more serious than the right's Jonathan Gruber fascination, since Walker was directly involved in implementing the law at the state level (as opposed to being a number-crunching advisor on the periphery). If the folks behind the King lawsuit are right -- they're not, but if they are -- governors were given a threatening message that they had to create an exchange in order to receive subsidies. Here's Walker -- no fan of "Obamacare" or the White House -- saying the exact opposite, on the record and out loud
Betsy Woodruff had a good piece on this overnight, noting that the governor's comments "could be a big problem ... for his party's efforts to stop the ACA."
Finally, Republicans have also quietly been signaling to the Supreme Court that ruling against the administration in the King case wouldn't destroy the American system, so far-right justices can rule without concern for the consequences. This assertion is now literally unbelievable -- the RAND Corporation reported yesterday that a Republican win at the Supreme Court would force 9.6 million Americans to lose their health insurance, send premiums soaring, and disrupt the entire system of private insurance.
That'd be quite a catastrophe over the perception of a drafting error.