The Supreme Court will hand down a ruling in King v. Burwell
sometime over the next several days -- possibly as early as this morning -- leaving much of the political world to wonder how much
damage, if any, Republican justices intend to do the American health care system.
While we wait, however, the legal controversy comes against an amazing backdrop. Despite the partisan peril the Affordable Care Act faces, the system itself has never been stronger or more effective. The latest CBS News poll
even shows rising popularity for "Obamacare."
As the U.S. Supreme Court prepares to issue a ruling that could impact the Affordable Care Act, 47 percent of Americans now approve of the health care law, the highest in CBS News and New York Times polling (although support is still short of a majority). For the first time, more Americans now approve than disapprove of the ACA, but by a narrow margin.
Less than a third of the country supports the Republicans' repeal agenda. What's more, a whopping 70% of Americans believe the Supreme Court should leave the current subsidies in place -- only half of GOP voters agree with their own party's litigation -- while 64% want Congress to protect the subsidies if the court strikes them down in states without their own exchange marketplaces.
But public attitudes are really just part of a broader success story. We learned on Tuesday, for example, that one of the ACA's principal goals -- expanding the availability to health insurance -- is being met with impressive efficiency. The New York Times reported
The share of poor Americans who were uninsured declined substantially in 2014, according to the first full year of federal data since the Affordable Care Act extended coverage to millions of Americans last year. The drop was largely in line with earlier findings by private polling companies such as Gallup, but was significant because of its source -- the National Health Interview Survey, a long-running federal survey considered to be a gold standard by researchers.
Paul Krugman raised
the prospect yesterday of the uninsured rate reaching its lowest point in American history.
What's more, the New York Times added today
that the system of subsidies -- the one that Republican justices may uproot -- is working exactly as intended.
More than seven million people are enrolled in the federal health insurance marketplaces, and a majority of them -- 87 percent -- receive subsidies in the form of tax credits to help pay their premiums, the government says. Without subsidies, many would be unable to buy insurance. The subsidies also appear to have drawn substantial numbers of younger, healthier Americans into the new insurance markets, stabilizing premiums, even for people who pay the full cost themselves. The subsidies average $272 a month, or $3,264 a year, and cover nearly three-fourths of the average premium for people receiving assistance, the government says. Beneficiaries are clustered in the lower income brackets, where the need has been greatest.
Meanwhile, beneficiaries are starting to panic about the prospect of GOP officials taking their health security away. The Wall Street Journal reported
this week, for example, on an Alabama community where many locals are terrified. "If they take Obamacare from me, I don't know what we're going to do," one woman said.
TPM published a related report
out of a rural community in Arizona, where even conservatives are desperately hoping the Affordable Care Act is left intact.
And Bloomberg Politics reported
on major hospital chains pleading with Republican officials not to take a sledgehammer to the system. One CEO said of Republican policymakers, "Any kind of thing to do with so-called Obamacare, they're opposed to. It doesn't matter if it's rational or not, if it's good for the state, it doesn't matter anyway. That's the biggest hurdle I see."
Watch this space.