1. Uncertainty keeps repeal flame alive The Supreme Court is coming at a time when theres an internal debate among Republicans about how the new Senate majority should approach the prospect of repealing Obamacare. Ever since the major provisions of the law went into effect Jan. 1, there’s been a debate within the Republican Party as to whether pursuing its full repeal was still a realistic option given that millions of Americans were receiving benefits. By taking up the case, the Supreme Court is already creating uncertainty about the law, which strengthens the case of the pro-repeal crowd that the law should not be viewed as a fait accompli. If the Supreme Court rules against HHS, it will bolster that view even more. 2. Americans lose subsidies Millions of Americans in 36 states who obtained insurance through the federal exchange (most associated with the healthcare.gov website) would lose those subsidies, thus making it more expensive for them to purchase coverage, meaning that many would wind up uninsured. On the flip side, federal taxpayers would save hundreds of billions of dollars over the next decade, because the government would no longer have to pay out these subsidies. 3. The employer mandate won’t apply in 36 states The (currently delayed) requirement for larger businesses to purchase insurance for their workers or pay penalties is triggered in cases in which at least one employee obtains government subsidies to purchase insurance. In states where subsidies cannot be distributed, the penalties wont apply. Therefore, a ruling against the government could set up a scenario in which businesses want to flock to states with federal exchanges as a way of getting around the employer mandate. 4. The individual mandate would apply to fewer people One of the ways an individual can be exempted from the requirement to purchase insurance is if theres no affordable insurance option available (defined as costing more than 8 percent of household income). Strip away the subsidies, and more Americans are going to fall into the exempt category. With fewer people subject to the individual mandate, it could also rock insurance markets if it turns out that the newly-exempt population skews toward younger and healthier individuals who would now be leaving the insurance market. 5. Life gets harder for Republican governors When it comes to Obamacare’s exchanges, Republican governors have been able to have it both ways. By refusing to set up state-based exchanges, they’ve been able to boast to conservatives that they rejected Obamacare. But because the Obama administration has been giving out subsidies in their states anyway, benefits are flowing to their residents. If the federal exchange subsidies were ruled illegal, however, governors would be in a tight spot. Conservative activists would be pressuring them to hold the line and refuse to set up their own exchanges. But there would be an uproar from liberal groups, newspaper editorial boards, hospitals and insurance lobbyists, and protests from individuals who had been receiving subsidies and would be facing the loss of their insurance. They would be under serious pressure to get the subsidies flowing by setting up state-based exchanges. 6. Obamacare gets re-opened by Congress Given all of the potential issues raised above, it could force the Republican Congress to re-open Obamacare to substantial revision. Among other issues, it would be difficult to sustain having mandate penalties being handed out in some states and not others, for instance. And it would be hard to justify keeping many of the laws tax hikes if the program is spending a lot less on subsidies. washingtonexaminer/six-potential-effects-of-a-supreme-court-ruling-against-hhs-on-obamacare/article/2555905
Posted on: Sat, 08 Nov 2014 02:12:10 +0000
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