The Cost Of Obamacare Repeal

The GOP wants to run on repealing Obamacare in the upcoming elections?  How will that play at the state level?  A new Department of Health and Human Services report documents the impact federal subsidies under Obamacare are having on the insurance costs of people receiving them, and the Plum Line gives the bottom line:

But if subsidies were repealed, people would not lose coverage, instead seeing premiums jump from loss of the tax credit.

– In North Carolina, 357,584 people are paying an average monthly premium of $81 — and repeal would result in an average monthly loss of subsidies/cost increase of $300.

– In Michigan, 272,539 people are paying an average monthly premium of $97 — and repeal would result in an average monthly loss of subsidies/cost increase of $246.

– In New Hampshire, 40,262 people are paying an average monthly premium of $100 — and repeal would result in an average monthly loss of subsidies/cost increase of $290.

– In Louisiana, 101,778 people are paying an average monthly premium of $83 — and repeal would result in an average monthly loss of subsides/cost increase of $314.

– In Iowa, 29,163 people are paying an average monthly premium of $108 — and repeal would result in an average monthly loss of subsidies/cost increase of $243.

– In Alaska, 12,890 people are paying an average monthly premium of $94 — and repeal would result in an average monthly loss of subsidies/cost increase of $413.

– In Georgia, 316,543 people are paying an average monthly premium of $54 — and repeal would result in an average monthly loss of subsidies/cost increase in premiums of $287.

Let that be known.

UPDATE: Apparently, the courts are doing it for the GOP.  This morning, the D.C. Circuit court (the most conservative of the circuit courts) ruled in a case called Halbig v. Burwell.  Here is the D.C. Circuit Halbig ruling:

A federal appeals court dealt a huge blow to Obamacare on Tuesday, banning 
the federal exchange from providing subsidies to residents of the 36 states it serves.

A divided three-judge panel on the D.C. Circuit Court of Appeals ruled that the text of the Affordable Care Act restricts the provision of premium tax credits to state-run exchanges. The two Republican appointees on the panel ruled against Obamacare while the one Democratic appointee ruled for the law.

"We conclude that appellants have the better of the argument: a federal Exchange is not an 'Exchange established by the State,' and section 36B does not authorize the IRS to provide tax credits for insurance purchased on federal Exchanges," Judge Thomas B. Griffith wrote for the court in Halbig v. Burwell.

His ruling was joined in a concurring opinion by George H. W. Bush-appointed Judge A. Raymond Randolph, who said it would be a "distortion" to let the federal exchange provide subsidies. "Only further legislation could accomplish the expansion the government seeks," he wrote.

Carter-appointed Judge Harry T. Edwards voted to uphold the subsidies.

"This case is about Appellants’ not-so-veiled attempt to gut the Patient Protection and Affordable Care Act," Edwards wrote in his dissenting opinion.

The ruling is very troubling for the Obama administration because the subsidies are critical to the success of Obamacare. The law encourages states to build their own exchange, but if they don't the federal government operates one on their behalf. The subsidies, or premium tax credits, exist to help Americans between 133 percent and 400 percent of the poverty line buy insurance. That imperils the practicality of the individual mandate to get covered and the market regulations to protect sick people.

UPDATE #2:  Fourth Circuit to the rescue.  A few hours after this morning's D.C. Circuit case, the also-conservative Fourth Circuit comes out with an opinion in King v. Burwell, which goes in the other direction and upholds the subsidies in Obamacare.  The opinion is here.

Money quote:

No case stands for the proposition that literal readings should take place in a vacuum, acontextually, and untethered from other parts of the operative text; indeed, the case law indicates the opposite. National Association of Home Builders v. Defenders of Wildlife, 551 U.S. 644, 666 (2007). So does common sense: If I ask for pizza from Pizza Hut for lunch but clarify that I would be fine with a pizza from Domino’s, and I then specify that Iwant ham and pepperoni on my pizza from Pizza Hut, my friend who returns from Domino’s with a ham and pepperoni pizza has still complied with a literal construction of my lunch order. That is this case: Congress specified that Exchanges should be established and run by the states, but the contingency provision permits federal officials to act in place of the state when it fails to establish an Exchange. The premium tax credit calculation subprovision later specifies certain conditions regarding state-run Exchanges, but that does not mean that a literal reading of that provision somehow precludes its applicability to substitute federally-run Exchanges or erases the contingency provision out of the statute.

UPDATE #3:  I didn't realize this before, but the DC Circuit opinion was en banc.  It was not the full circuit.  Therefore, the 4th Circuit "wins" out for now.  The Obama administration is appealing the DC Circuit opinion to the full DC Circuit.

What do you think?