President Barack Obama sought Monday to portray the latest lawsuit against the Affordable Care Act as baseless litigation founded in political animus—and warned that a Supreme Court ruling against his administration, which could come any day, would be devastating

The president said it was “well documented” that Congress intended for the ACA’s subsidies to be available in every state, regardless of whether the state or federal government operated its insurance exchange. But the law’s opponents disagree, citing some specific wording in the statute itself, and now the Court will decide the matter in the coming weeks…

“I’m optimistic that the Supreme Court will play it straight when it comes to interpretation,” he said. “And I should mention if it didn’t, Congress could fix this whole thing with a one-sentence provision.”


“Let’s be clear: if the Supreme Court rules against the Administration, Congress will not pass a so called ‘one-sentence’ fake fix,” Wyoming Senator John Barrasso, who is leading Republican efforts to craft a contingency plan, said in a statement…

In his statement, Barrasso accused Obama of “bullying the Supreme Court” and said the Republican-led Congress is “prepared to help” Americans who may be harmed.

But is it? Republicans have struggled to coalesce around a contingency plan if the ruling goes their way. A victory could backfire on the GOP without a viable response, as Democrats would be armed with attack ads accusing them of pushing for a ruling that threw millions of Americans off their health care plans without a plan to help them.


What’s more, the ruling might send the individual insurance markets in the affected states into what economists call a “death spiral”: The higher premiums would mean that only the sickest and most desperate buy insurance. That would cause premiums to rise even more.

That scenario would pressure Republicans on multiple levels. In the states, officials who until now have resisted Obamacare would face calls to set up exchanges so that residents could continue to collect the tax credits. In Washington, Republican lawmakers would suddenly have to shift from trying to dismantle Obamacare to managing the fallout.

“If the Supreme Court rules against it, they’re going to have to have an answer for the millions that now are relying on this insurance,” said Ron Bonjean, a Republican strategist and ex-aide to former Senate Majority Leader Trent Lott of Mississippi. “They’ll have to provide a credible alternative.”…

“I’m not sure it will be enough to say, ‘We’ve got an approach but the president will veto it,'” said Karlyn Bowman, a public opinion specialist at the American Enterprise Institute in Washington. “Something will have to happen pretty quickly so those people are not without coverage.”


[A] SCOTUS ruling against the Obama administration would eliminate those job-killing mandates. Media coverage concerning King v. Burwell has focused on the loss of subsidies that some would face if the Court rules in favor of the plaintiffs, and a few million people may indeed have to pay the full price of their own Obamacare coverage. But that’s only a small part of the story. Such a ruling would emancipate 11.1 million people from the individual mandate, according to a study recently released by the American Action Forum (AFF), which also estimates that 262,000 businesses would be freed from the law’s employer mandate.

The economic advantages of manumission from Obamacare’s mandates would be numerous. Employers would no longer be incentivized to forego expansion and the creation of new jobs. Nor would they face pressure to replace full-time employees with part-timers or to hold the latter to fewer than 30 hours per week. The study’s authors estimate that these changes could produce 237,000 new jobs, add nearly 1.3 million workers to the labor force, and improve the plight of 3.3 million part-time employees who would no longer face an impediment to getting more hours. They estimate that all this will result in a $13.6 billion increase in total pay…

This headwind will dissipate somewhat if the Court rules for the plaintiffs in King v. Burwell. As the AAF study notes, “Almost 11.1 million individuals will become eligible for an exemption from the individual mandate penalty… employers will also be released from the employer mandate penalty, which could lead to wage increases… and would eliminate employment restrictions that have left 3.3 million part-time workers unable to work more hours.” All of this will pump money into the economy, eliminating negative growth and sluggish job gains. The Democrats and the media will no doubt heap praise on SCOTUS for this service.


Two states — Pennsylvania and Delaware — said this week they would launch their own exchanges, if needed, to keep millions of healthcare dollars flowing after the decision. Both want to use existing pieces of the federal health insurance exchange, like its website and call center — a path that would be far less costly than the way most other states have created their exchanges…

“I think that’s a pretty easy workaround,” Thomas Scully, the former director of the Centers for Medicare and Medicaid Services during the George W. Bush administration, said about the two states’ plans…

A multi-state exchange — an option buried in the text of the Affordable Care Act that has recently seen resurgence — could also cut costs, Crippen said Friday…

“You can hire whoever the hell you want as a contractor,” he said. “You can contract a bunch of people in Philippines to do a call center. Why can’t you contract CMS for an exchange?”


But the dirty secret is that insurers stand to lose the most from King v. Burwell.

The Affordable Care Act compels the public to buy their product, and forces taxpayers to subsidize it. What a sweetheart deal.

The giant players — United Healthcare, Cigna, Aetna, Anthem and Humana — have seen stock prices double, triple, even quadruple since the law was passed in 2010. The coming ruling threatens to put an end to their gravy train…

No one will lose their coverage immediately, the poor will be unaffected and the biggest losers will be insurance companies.

Employers, job-seekers and taxpayers actually stand to win here.


The Affordable Care Act hangs in the balance in the Supreme Court for the second time in three years, but the public has rendered a judgment ahead of the court’s ruling. By a margin of 55 percent to 38 percent, more people say the court should not take action to block federal subsidies in states that didn’t set up their own exchanges, according to a new Washington Post-ABC News poll…

Public opinion on providing subsidies splits in predictably partisan ways — but not overwhelmingly so. Nearly two-thirds of Democrats (65 percent) say the court should not take action to block health insurance subsidies. Fifty-five percent of Republicans say the court should rule against the subsidies. Independents side with keeping subsidies, 57 percent to 36 percent…

The disconnect in the new poll — that a majority opposes the law, while a nearly equal majority does not want the Supreme Court to rule against it — is driven by political independents as well as Republicans. Independents oppose the law 56 percent to 35 percent. But they also want a ruling in favor of subsidies by almost exactly the same margin. Likewise, although only 19 percent of Republicans support the law, 34 percent say the court should not block subsidies to low- and moderate-income people.



Some Democrats, meanwhile, say a Supreme Court win for the White House could finally mean Republicans give up the fight over Obamacare.

“I think they’ll see that the American public is firmly and unequivocally benefitting from this law and they’ll make their peace with it,” said Sen. Richard Blumenthal.

Other liberals also see the case as a tipping point for the law’s acceptance. The discussion could then turn to perfecting the law.

“I think that’s going to send a clear signal around the country. And the signal is that the Affordable Care Act is essentially a permanent part of America’s health care system,” said Ron Pollack, executive director of Families USA. “I think it’ll say that a corner has been turned and it will no longer be a credible debate to think about undermining or repealing the Affordable Care Act.”…

In the meantime, everyone waits for the Supreme Court.