It is the worst nightmare of fearmongers — nothing can be worse for someone’s credibility than for something they have spent years attacking and demonizing to succeed. This is the case for the Patient Protection and Affordable Care Act, popularly known as Obamacare. This is an act so ridiculed by right-wing media and politicians that their vitriol almost became the norm. Even democratic supporters turned their backs on an initiative that many thought was too politically toxic to take on, while placing the blame on President Obama. However, in the year since it was implemented, Obamacare has been an unqualified success.
The percentage of unemployed Americans dropped sharply as nearly 9 million Americans got insured as a result of Obamacare provisions. Premiums are also lower than predicted. Additionally, the Congressional Budget Office predicts costs for Obamacare are going to be 20 percent less than expected. Premiums, when subsidies are accounted for, are low as well.
There is, however, something that can derail this astonishingly unrecognized source of good. King v. Burwell, a recent Supreme Court case, has the potential to throw Obamacare into the death spiral of rising premiums and declining enrollment.
The mechanism for the potential demise of Obamacare can be found in ambiguous wording in the original law. The claim by the plaintiffs is that the IRS illegally provided subsidies to individuals who purchased coverage through exchanges set up by the federal government. This is because the original act specified that the subsidies would be provided only for insurance bought through the state. The plaintiffs allege they are being hurt by subsidies because if the IRS had not given them these illegal subsidies they would have qualified for exemption to the fine for being uninsured through the hardship clause.
The significance of this decision is that if these IRS subsidies are found to be illegal, about 8 million people could lose coverage by losing the subsidies that allow them to afford coverage. Premiums will rise approximately 35 percent, which in turn will cause more hardship and insurance dropouts. Such a change would be drastic and experts suggest that if the plaintiffs prevail, 10,000 people will die as a result.
A decision against Obamacare could cause the entire healthcare system to suffer falling enrollment, causing higher premiums which in turn cause falling enrollment; it becomes a positive feedback loop until the system collapses. Such a shock would wreck the healthcare system in the United States.
If this lawsuit succeeds, it will be disastrous, costly and against both precedent and principle. This could have simply been left to the lower courts; the Supreme Court didn’t even let it play out fully before accepting the case. Furthermore, it is not a case that has major constitutional implications. It is predicated on an ambiguous phrase, that the exchanges would only be allowed insurance bought through exchanges established by the “state” — that precedent says should be left up to the agency administering it — to interpret. The IRS interpreted this to mean the intent was that if the state could or would not set up its own exchanges, the federal government would step in and assume all its duties and powers, including the right to subsidies.
There is a chance that such an absurd, pointedly political argument could win. If that does happen, it will be worse than Bush v. Gore in its implications for trust in both Congress and the legal system. People will lose trust in the ability of Congress to fix the problem, and the courts for causing it in the first place.
The fact of the matter is if the plaintiffs win, they will cause a huge amount of damage to individuals and public trust in our institutions. The only justification is pure hatred for Obamacare and our president, which two of the plaintiffs have openly expressed on social media. The combination of misinformation — one plaintiff claims that Obama is not our real president — and hatred is a source of the poison that damages the reputation of a beneficial, successful government program.
Sawan Patel is an Opinion Columnist for The Cavalier Daily. He can be reached at s.patel@cavalierdaily.com.
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