Friday, November 14, 2014


Greg Sargent believes that a Supreme Court ruling invalidating Obamacare subsidies in states that use the federal exchange could create a real dilemma for governors and legislators in certain states:
A SCOTUS ruling against Obamacare: Health care for the poor, but not for the working middle class?

If the Supreme Court kills Obamacare's subsidies to people in the states on the federal exchanges, more than four million people in those states would likely see their premiums rise, probably forcing many to drop health coverage altogether.

This will create a very interesting question for Republican governors and legislators in some of these states, one with implications that people haven't gamed out yet.

The question is this: Will these legislators really support federal money flowing into their states to help poor people continue to get health care, while opposing federal money flowing into their states in a way that could result in working and middle class people losing their health care?
Sargent's point is that there are fifteen states that didn't set up exchanges (which means their middle-class Obamacare customers will lose subsidies if the Supreme Court rules for the plaintiffs in the current suit) but did opt into the Obamacare Medicaid expansion. As Sargent writes,
... now, in these states, if the subsidies are nixed, the Medicaid expansion will remain. And that means, suddenly, a situation in which poor people's health coverage is being subsidized by the feds, while the health coverage of slightly better off people, folks who are more likely to be working, is not -- leaving them potentially without it.
Sargent thinks this could goad state officials to switch to state exchanges, so that their middle-class citizens will be covered, too. I'm thinking something far more cynical: that Republicans will be delighted by this outcome, because it reinforces their argument that Obamacare -- and, really, all government programs except Social Security and Medicare -- are just ways of taking hardworking taxpayers' dollars and transferring them to the lazy and the shiftless.

The states in question are Arizona, Arkansas, Delaware, Illinois, Iowa, Michigan, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oregon, Pennsylvania, and West Virginia. I don't know what you see when you look at that list, but I see a lot of electoral votes. I think Republicans would love to have the "takers" getting subsidized health coverage while the "makers" pay full price in the run-up to the next presidential election in Delaware, Illinois, Iowa, Michigan, New Hampshire, New Jersey, New Mexico, and Ohio, Oregon, and Pennsylvania. All of those states have gone Democratic in recent presidential elections, but most of them have Republican governors who would resist setting up state exchanges so the middle class could get a break, simply because they're Republicans.

I think resentment of this situation could enrage quite a few swing voters -- and given the fact that so many of these states have Republican governors but voted for Obama twice, I'd say the states have a lot of swing voters.

I know I'm supposed to see this as an opportunity for voters to see the cruelty of Republican policies, and to demand and get a break for themselves, but if the last six years have taught me anything, it's that Republicans have a cloak of invisibility -- or invincibility -- as long as there's a Democrat in the White House. Voters just don't see what Republicans are doing; they blame everything they don't like on the president. I don't think they'll pressure their Republican governors to set up exchanges; I think they'll just fume and blame Obama.

So I think Republicans look at the situation Sargent is describing and regard it as a feature, not a bug.


Nefer said...

The shame of it is that Democrats, especially those running for office will not stand and shout from the rooftops what is going on.

Instead they will accept the republican/media claim that Obamacare is a failure, and those running for office will claim that they disagree with the President on well, everything.

I hate feeling cynical but I am still upset with Begich, Pryor, and Grimes.

Especially Grimes, who could have told Kentuckians over and over again that their beloved Kynect was, in fact, Obamacare, and that McConnell had promised to take it away from them, but that she would protect it.

Would she still have lost? Maybe, but she could hold her head high, knowing that a seed of doubt had been planted that would sooner or later turn Kentucky blue.

Victor said...

"And that means, suddenly, a situation in which poor people's health coverage is being subsidized by the feds, while the health coverage of slightly better off people, folks who are more likely to be working, is not -- leaving them potentially without it."

Yup, Steve - more fertilizer to nourish "Divide and Conquer."

And John Roberts, that slick sociopathic conservative (but I repeat myself) MFer, will do exactly this.

John Taylor said...

I am wondering what the reaction will be in states that refused Medicaid and to set up exchanges. Would it not be hard to blame Democrats for this? I'm disappointed with Grimes, also. A great opportunity was missed to overturn the turtle. What a coup that would have been!

sdhays said...

I don't doubt that if the Supreme Court does gut the subsidies on, this will be the next step for Republicans. However, this would be a pretty clear case of "Democrats gave you money, Republicans took it away". Even people barely paying attention would know that subsidies not going to the middle class would be completely due to Republicans (and Democratic incompetence). For Mark Kirk's sake, I hope that the new RWNJ Governor of Illinois doesn't decide to play games and not take advantage of whatever process the Obama administration comes up with for getting around the Supreme Court's nonsense; I don't think he'll stand a chance in 2016 otherwise. (I also hope that he doesn't play games because that could really cause a lot of pain and hardship for a lot of people, including some that I know personally, but like you said, that's not typically something Republicans concern themselves with.)

Obviously, Democrats are completely capable of failing to capitalize on that vulnerability, but I think the situation would be clear enough on its own that Democrats could do a crappy job and still get anger appropriately directed. And I think that this particular issue isn't particularly controversial along the Democratic spectrum, so I think, unlike most issues, you'd probably see full-throated rage from the Democrats in those states, which would probably not work out in the Republicans favor come 2016. I don't think flipping the House in 2016 is very likely (the Senate is more possible), but if there was one issue that might do it because it would enrage the Democratic base to 2006 levels, the Supreme Court taking away subsidies and Republican governors in swing states refusing to restore them "because reasons" would be my best bet.

A lot caveats there, but I don't think Republicans in those states would welcome the Supreme Court forcing them to make a decision.