A ruling that came out this morning dealt a very severe blow to the Affordable Care Act. The ruling in Halbig v. Burwell states that persons who applied for insurance through the federal exchange on healthcare.gov are ineligible for subsidies of their premiums.
This stems from the actual language of the law stating that subsidies are available for people enrolled through “an Exchange established by the State.” Since 34 states did not create their own exchanges and the federal government, through healthcare.gov, established it for those states, no person in any of those states is eligible for subsidies. Most of the 34 states opting out are Republican states, including our state of Oklahoma and our neighbor Texas.
What does all of this mean? Well, as I am a tax attorney, for me it means that Obamacare just became a lot more budget friendly. The estimate on subsidies that will be cut off are about $36 Billion per year for up to 7.3 million people. (Essentially the vast majority of persons who signed up under the ACA only did so because they would receive subsidies.) The latest CBO report I saw estimated that Obamacare would run a $2 Trillion dollar deficit over the next ten years. If you take out $360 billion+, then it cuts the expected deficit by about 20%.
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What are the takeaways from this? First, the Congress that passed this hastily in 2010 needs to bear all of the blame. The law was passed by reconciliation through only one party’s votes. As Kevin W. Glass said about the ruling, “You write bad laws, you get bad laws.” Second, it is likely that poorer, healthy enrollees will drop out of the insurance marketplace, electing to pay the “tax” instead. Third, the insurance market will likely have to be directly subsidized, because if this law is not repealed, the whole industry will collapse under the weight of covering bad risk enrollees.