Beep Beep

The Chase.  The endless effort to reach that which is just beyond our grasp has piqued our imagination since we, as small children, watched the Coyote try to capture the Roadrunner.  We knew, instinctively, that the Coyote would never succeed.  But what if he did?  What if the Coyote actually had his arms wrapped around the Roadrunner?  Would he know what to do?

The Coyote’s struggles are humorous entertainment.  The Republican’s efforts to eliminate or destroy the Patient Protection and Affordable Care Act (PPACA) have been just as entertaining if your tastes run towards political drama.  John Boehner and the Republican controlled House of Representatives have been chasing the PPACA for nearly four and a half years.  What would Boehner do if he actually got his hands on the PPACA, if the law was crippled or repealed?  We may soon find out.

This blog has long contended that the PPACA is a poorly written law in desperate need of tweaking.  Today’s problem revolves around the issue of subsidies.  The law was designed, in part, to help the working poor to acquire and PAY for quality health insurance.  The law’s framers envisioned individuals and families accessing a system of simple, online, state-based marketplaces and, when appropriate, tax credit subsidies to help with the premiums.  The process wasn’t all that easy and over two thirds of the states decided not to build an exchange.

Creating a state-based exchange requires an incredible amount of time and energy.  Some states see this as a huge waste of resources.  Others, like Oklahoma, have no interest in participating in the PPACA.  The federal government created the much beloved healthcare.gov so that the millions of residents in states like Ohio could purchase coverage and qualify for the tax credit subsidies.

This past Tuesday the U.S. Court of Appeals for the District of Columbia ruled (2-1) that people purchasing coverage through the federal exchange are not eligible for the subsidies.  Sure, a couple of hours later the 4th U.S. Circuit of Appeals in Richmond, Virginia reached the opposite conclusion (3-0) on a similar case, but the door had been flung open.  One side or the other can still appeal, but the conflicting decisions, alone, may be enough to get this matter before the Roberts’ Supreme Court.

Could the Supreme Court eliminate the tax credit subsidies, the only way millions of Americans can afford to pay for health insurance?  Yes, they could.  Would the Supreme Court gut the PPACA?  Who knows?  Based on the Court’s recent decisions, any outcome is possible.

If the Supreme Court takes this case, I suspect that it won’t be until the fall of 2015.  That means that a decision would be handed down in June 2016, right in the middle of a Presidential election.  So let’s explore what would happen if the Supreme Court ruled that tax credit subsidies were only available on policies purchased on state-based exchanges.

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