Marc Yacht: Republicans now fret high court may boot Obamacare

The Washington Post commented in 2014 that since Republicans took control of the House they have voted 54 times to undo, revamp or change Obamacare. Those unsuccessful efforts have cost taxpayers a bundle and wasted lawmaker time, time better spent attending the nation’s needs.

The anticipated U.S. Supreme Court ruling on King v. Burwell will determine the fate of Affordable Care Act subsidies to millions of low-paid workers in about three dozen states using Federal exchanges. If the court rules against the Federal subsidies, insurance premiums could triple to those families receiving premium assistance. That ruling would certainly mean the loss of affordable health coverage to those families.

Republicans who have left no stone unturned in efforts to crush Obamacare are having second thoughts as they realize 6.4 million could lose their health insurance. The chaos created by such action lies at the feet of conservative Republicans and the ultimate cost at the polls is yet to be determined. It reminds one of the adage, “Be careful what you want; you may get it!”

Although Republicans keep touting their efforts for a better health plan no plan has surfaced. Millions of Americans abruptly losing health coverage is not an easy swallow to conservative warriors. It should be noted that many hardcore Republicans who are low wage earners will be among those losing precious health coverage for their families.

There are Republican concerns that should the ruling go against Obamacare subsidies, the Obama administration will showcase a litany of chronically ill patients no longer covered for their medical needs. Even the cruelest Libertarian would find such a parade of tragedy upsetting.

Florida would be most affected in terms of the number of people losing subsidies (1.3 million) and the total monthly value of those subsidies ($389 million), with Texas ranked second in both categories (832,000 residents losing a total of $206 million per month), according to a Kaiser Family Foundation analysis of the new federal data.

Florida Gov. Rick Scott has said he will not assist those losing subsidies: “I think it has to be a Federal fix.” Scott has made no meaningful effort to cooperate with the Affordable Care Act since its inception.

Responsible Republicans concerned about 6.5 million people losing health insurance are advancing alternate plans that would protect those now with health insurance but not allow additional enrollment in the affected states. The Obama administration has seen no such plan and is making no comment. President Barack Obama has stated that the Supreme Court should not be addressing this issue, but is awaiting its decision on the case.

There are many back room discussions by both parties as they look for  alternatives should the ruling go against the subsidies. Because states with their own exchanges are not affected by the ruling, Democrats are looking to simplify and encourage Federal exchange states to convert to state exchanges. Republicans hope to protect those with insurance but still want to dismantle Obamacare.

There are 12.7 million ACA exchange policy qualified health enrollments. According to the Robert Wood Johnson Foundation 6.5 million could lose their tax credits and affordable insurance. The Supreme Court sets aside emotion when making decisions. It looks solely at the arguments and the law. 

A ruling is eminent.

Marc J. Yacht M.D. is a retired physician living in Hudson, Fla. This column courtesy of Context Florida.