If the plaintiffs win the current Affordable Care Act (ACA) case before the U.S. Supreme Court, King v. Burwell, millions of Americans who bought health insurance through the federal marketplace or “exchange” will lose the federal tax dollars they’re getting to help buy their policies.
That’s because the Court would have ruled the ACA only allowed subsidies to be given to those buying policies on state-established exchanges; not the federal website.
It would theoretically be a victory for Republicans who oppose Obamacare: Americans would likely find the health care law less palatable if tax money isn’t helping pay for their mandatory policies. They would suddenly be exposed to the reality faced by those who aren’t getting subsidies: insurance may cost more, come with higher deductibles, and provide less coverage.
But some Congressional Republicans are more worried about winning the Supreme Court case than losing it.
“There are Republicans right now scared to death that we’re going to win,” says one Republican leader who did not want to be quoted by name. “They’re in meetings right now planning ways to revive the subsidies if the [Supreme] Court strikes them down.”
The irony is that Republicans would, in effect, be providing a crucial fix to a law they’ve opposed since its inception. In other words, when Obamacare would be at greatest risk of crumbling, Republicans would be ensuring its survival.
According to a dozen Congressional Republicans who discussed the topic but did not wish to be named, they worry the public wouldn't view a strike-down of the subsidies as a weakness in Obamacare, but would instead blame Republicans for taking money away from them.
These Republicans also worry that the news media will coalesce behind that view, making it difficult to overcome from a public relations standpoint.
Politico reports that 31 senators are backing a bill by Sen. Ron Johnson, R-Wisconsin, that would restore subsidies for the affected Obamacare customers through September 2017.
Large percentages of those polled say they would support a fix if the subsidies are found to be unlawful. Significant numbers of those polled don't understand how the federal and state exchanges work.
Poorest Americans Will Still Receive Free Health Care
Meantime, there’s has been a great deal of misreporting implying millions will lose their health insurance if the Supreme Court wipes out subsidies for federal exchange customers.
In fact, such a decision wouldn’t remove anybody’s health insurance and those affected would still be required, under Obamacare, to have insurance; they would just have to pay for it themselves.
For example, under Obamacare, a couple earning as much as six figures with three children is currently eligible for taxpayer assistance to buy health insurance. If plaintiffs win the Supreme Court case, nothing would change for that family as long as they purchased their health insurance through a state exchange. If, however, they bought insurance through the federal website, they would lose their subsidy.
The poorest Americans will be unaffected no matter what the Supreme Court decides. They have long had free health care under Medicaid insurance for the poor. Under Obamacare, many states, such as California, extended Medicaid to people making more money than before, such as a couple with three children earning $39,206 a year.