A Whole Bunch MORE Reasons why Republicans are Freaking Out over King v. Burwell

Mon, 06/22/2015 - 9:14pm

Note: My estimate for Alaska is actually slightly lower than this (16K), and my estimate of the average tax hike those Alaskans would have to pay is actually half of the amount in the article ($3,200 vs. $6,400), but that's because I'm assuming only the 2nd half of the year's credits would be rescinded:

Robin Barker, a longtime resident of Fairbanks and Bethel, struggled with chronic illnesses for years that kept her from working. Her only option for health insurance cost nearly $800 a month for a policy that came with a $15,000 deductible. Prescriptions alone set her back $12,000 a year.

“Money was just pouring out of our retirement savings,” she said.

...Interviewed at her Fairbanks home as she recovered from a bout with pneumonia, Barker said she was happy to qualify for Medicare but was concerned about Alaskans who won’t be able to afford health coverage if the U.S. Supreme Court strikes down subsidies. If that happens, she says, “families will be destroyed.”

Virgil Porterfield in southern Missouri minces no words when he says what it would mean for him and his wife if the US Supreme Court rules against the Obama administration in a case this month.

“It would be the difference between having medical insurance and not,” says Mr. Porterfield, a former worker in the oil and gas industry who, at age 63, is not yet eligible for Medicare.

...But on the ground, in places from Pensacola, Fla., to tiny Pineville, Mo., the court case could have major financial repercussions for many Americans like Porterfield.

...In Kalamazoo, Mich., Michelle Serlin is another person who worries about the potential loss of subsidies. She runs a counseling and therapy practice, and says the ACA has delivered an affordable option that she hadn’t been able to find before.

...“This is not welfare for people that are not working,” she says, explaining that the subsidies help everyone from business owners to college instructors who don’t teach enough to be covered by their employer.

...Near Houston, Mike Siegel is a small business owner who got coverage through Obamacare for his family of three.

“I don't think people really understand what Obamacare is,” Mr. Siegel says, referring to opposition to the law from his Republican friends. “From my perspective all Obamacare is, is going to a website and getting insurance” at a better price.

...If the court nixes subsidies, Siegel says he’d go shopping in the private insurance market, possibly finding a plan for about $1,000 per month with a very high deductible. And if that happens, “I'm going to have to get rid of something else in my budget.”

Barbara Butler takes home $250 a week for driving a school bus with blind children to a Catholic day school part time. Her health insurance premiums are $517 a month. She pays 76 cents, and Washington picks up the rest.

The Supreme Court is expected to rule within a week on whether that subsidy, a key part of President Obama's health-care law, is legal in 34 states. If it decides not, then the West Philadelphia resident's premiums would swell to half her income.

"Fortunately for me, I'm pretty healthy," Butler said. So she would go without coverage.

...Raymond Castro, an analyst for New Jersey Policy Perspective, recalled what happened five years ago when state officials, to save money, ended an optional Medicaid program for legal immigrants.

"As soon as they did that, they got calls from hospitals saying: 'This person is in the middle of treatment. If this person doesn't get a heart transplant, he will die,' " Castro said. The state ended up reimbursing hospitals for a portion of cases, he said.

Kay Arthur moved to Dublin from West Virginia to become the full-time caregiver to her 91-year-old mother.

After her husband’s death in October 2012, Arthur briefly retained health insurance through his employer. But when that coverage ended, a pre-existing health condition threw up hurdles to finding a new health plan.

So she turned to the new federally run health-insurance marketplace and found a policy with a $2,500 deductible. A $182-per-month tax credit made her premium more affordable.

...For Kay Arthur, a court decision striking down the subsidies could force her to adapt to far less comprehensive coverage.

“I could manage,” she said, “but it concerns me that there are a lot of people that could have more trouble.”

“I’m in the doughnut hole,” said Lily Estes, 56, a resident of the Gilpin Court public housing project in Richmond who earned just enough income this year to qualify for a subsidy that covers the cost of a health plan she bought in the marketplace. Without the subsidy, she cannot afford the insurance.

The loss of the subsidies would fall especially heavily on people earning between 100 to 250 percent of the poverty level — $11,770 to $29,425 a year for a single person — who also would lose cost-sharing subsidies for co-payments and other out-of-pocket expenses.

“They’re all going to be hurt,” said Deborah Oswalt, executive director of the Virginia Health Care Foundation, which tries to expand care of the uninsured in free clinics and community health centers.

Marilyn Lynch of Kansas City could lose her health insurance this year. So could Kristine and Kenny Cloughley of Pleasant Hill. So could tens of thousands more in Missouri and Kansas, and millions nationwide.

...Lynch is an actor — she’ll be appearing later this summer in the Kansas City Actors Theatre production of “The Gin Game” — who works part time at a marketing firm to make ends meet. She used to be able to afford health insurance but had to give it up.

“Every year I got older, and the premiums rose exponentially,” she said. “It was that or eat.”

Lynch stopped seeing her doctor. She stopped taking medication prescribed for her high blood pressure. It was an anxious time.

“I don’t want anything to come raging back at me,” she said. “I want to stay in good health. I don’t want to be a burden to my children.”

...Kristine and Kenny have been getting their insurance through the ACA exchange, paying about $300 out of pocket each month, after a subsidy of about $250.

“We have deductibles that are reasonable, co-pays that are reasonable,” Kristine Cloughley said. “I can’t fathom what my cost of insurance will be without the subsidy.”

Kristine has a thyroid condition that requires regular medication. She was diagnosed a couple of years ago with a form of colitis. It’s under control now but could flare up again.

“I’m scared. I’m not sure what plan we could afford, but we wouldn’t be able to stay on the same one. I’m priced out of that.”

Stories like the ones above help explain why...

Given that political geography, the 2016 Republican candidates would not only have to respond to the problems the decision creates back home, but also answer for their health care positions in the general election battleground states that are grappling with the fallout.

The Republican field is irrevocably split, however, on what the fix should be if the Supreme Court throws out the subsidies, delivering what is looking less and less like a GOP victory on Obamacare, and more like a major policy headache. On the one hand, governors like Scott Walker of Wisconsin, Chris Christie of New Jersey and Bobby Jindal of Louisiana have refused to prepare a state-level response, arguing it’s for the federal government, not governors, to handle. On the other hand, Republican senators running for president, particularly Senator Ted Cruz of Texas, have been emphatic that Congress should not throw a lifeline to a health care program they loathe, a position reinforced by outside conservative groups.

Of course, this may all prove to be moot. Over at Forbes, Bruce Japsen lists five reasons why he's pretty confident that the Supreme Court won't rule for the plaintiffs anyway:

Whether the case comes down to Chief Justice Roberts or Justice Anthony Kennedy, there are reasons to bet against a majority of justices on the high court ruling against the Obama administration in the now famous case brought by opponents of the law who say tax credits were only intended for states that set up their own exchange.

Here’s fallout Justices will consider for millions of Americans:

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