Taking the Affordable Out of the Affordable Care Act

Screen-Shot-2014-07-22-at-11.40.12-AMShreveport          Two different federal appeals courts, one in the notoriously Republican-dominated, 2nd Circuit in Washington, DC, and the other a bit more mainstream in Richmond, Virginia came down with contradictory decisions on whether or not the Affordable Care Act allows subsidies to be given in the 36 states where Governors and state legislators have stood in the hospital door and the feds have run the marketplaces. Without the subsidies administered by the IRS, the mandate for health care coverage would remain, but the “affordable” would be taken out of the Affordable Care Act. There will be no change for now, but this means that Obamacare will be on tender hooks throughout the coming mid-term elections and its fate will rest with the deeply divided Supreme Court next year. I’m not sure there’s enough prayer to protect the American people from the fear all of us now must feel.

Sadly, this seems part of a pattern of pointed and specific attacks on the poorest Americans even while the editorialists try to summon up platitudes about the importance of dealing with the deepening inequality of American society.

Reports have gotten wide publicity that perhaps as many as 2 million of the 10 million applicants for Obamacare may have had defects of one kind or another in their applications. Government Accounting Office investigators reported to a Congressional committee as well that they were able to trick their way into successful applications with fake IDs and income information in 11 of 12 cases when they went undercover.

All of these are tentative indications of problems, so they may or may not indicate deeper issues. Furthermore, there is a mechanism to fix early certifications, so it is unclear whether this is really an issue at all. Any change of income or inaccurate filing is all settled up later with the IRS at tax time where additional charges and adjustments will occur. The back-end corrects any front-end problems.

Nonetheless there can’t be any doubt that Obamacare opponents are pointing their fingers again to paint a picture of an “undeserving” poor ripping off healthcare. The subsidies now at risk, thanks to Congressional polarization that left language in the Act vague without a conference committee to clean it up, also are of course only paid to make the care affordable for the poorest working families who qualified.

Add this to the failure to adopt the Massachusetts-style $2000 cap on deductibles which will penalize millions of lower wage workers once the mandates go into effect in larger companies, and it appears the war on the poor is being waged on all fronts.

Unfortunately without some breaks or a fix, this is a cage match to the death, and the betting odds will be heavily against us.