The US Supreme Court holds a monumental opportunity to wreak massive havoc on those of us who toil at our labor and scrape together meager earnings for necessities like housing, food, fuel and healthcare.
I’m talking about King v. Burwell, heard by the court last week. The court will decide whether to allow an ideologically driven lawsuit to sabotage the Affordable Care Act by picking apart a technicality in the healthcare exchanges. The technicality being that eligible citizens across the nation receive subsidies, whether through state exchanges or through the federal government where states have opted out, in violation, plaintiffs argue, of the law’s prescribed limit to exchanges “established by the State.”
We’ve been waiting for a decent national healthcare system since the Truman administration, if you really want to take it all the way back. But to tell the short history, it’s been since the 2008 presidential primary. We recognized then that it was a scandal that millions of people remained uninsured, denied the benefits of preventative medicine and dependent on emergency rooms for acute care. It was a scandal that people with pre-existing conditions — those who needed care the most — were denied coverage. It was a scandal that high costs of care, even for those with insurance, meant that one serious accident or illness could drive a family into financial ruin.
All the presidential candidates — Democrat and Republican — touted their plans to address the crisis. Barack Obama was by no means the most vocal, but he won the presidency and inherited the mandate for action. In an effort to preempt conservative objections against genuine national healthcare, Democratic lawmakers co-opted Republican ideas to preserve the role of the private insurance industry, while addressing concerns about cost and access by mandating coverage and providing subsidies to those who were priced out of the market. The public option — a piecemeal compromise in itself — was taken off the table. We ended up with a deeply flawed plan, but it was the best we could do under the political circumstances.
What role have the Republicans played in the state of healthcare in the past seven years? Did they offer meaningful alternatives before the law passed? Did they propose fixes to make the law work better? No, their record has been uninterrupted obstruction and gamesmanship. But down on the ground, some of us, including unaffiliated voters like me, really care about access to decent and affordable healthcare. For some of us, this is not a political game.
Reporting on healthcare and economic policy when the train is driven by conservative activists and lawmakers occasionally feels like being held hostage by an insane cult. Like a hostage negotiating her freedom, the person attempting to pin conservatives down on the rationale for their policies must adopt their language. The hazard of reporting is that the crazy person with whom one is dealing comes to appear reasonable simply because he wields power over one’s life.
How did we get to the place where the Supreme Court might blow up the Affordable Care Act on a mere technicality? Two reasons, both having to do with Republican obstructionism. One, Republican-controlled states like North Carolina refused to create state exchanges — an eventuality the drafters of the bill could not have anticipated. And the Republicans who now control both houses of Congress refuse to make a simple tweak to the law so that it specifies that all eligible citizens — regardless of whether their insurance is provided through a state exchange or the federal exchange — receive the subsidy (paging US Reps. Mark Walker and Virginia Foxx).
I used to hear that the Affordable Care Act undermined business owners’ ability to invest in their companies and create new jobs. Especially since my former employer at Yes Weekly made the argument, full of wounded self-righteousness and disdain for the president, I was hard pressed to challenge it. Now that I am a business owner myself (holding a 10 percent stake in this company), I understand the argument even less.
Considering that we’re a small company, each employee-owner purchases health insurance through the exchange. And considering that we didn’t make much money last year, I qualified for a $160-per-month subsidy. This makes a huge difference to my family. It allows us to avoid drawing down our personal savings while we’re working hard to help build this young company, with hopes to employ additional journalists in the future. It provides the financial stability to consider buying our own home.
It would be a pretty significant setback to lose the subsidy, and most likely give up coverage and pay the fine instead. This is very real to us.
I thought that entrepreneurship and homeownership were public-policy goals that Republicans embraced.
Please explain to me how assaulting healthcare for those of us with ordinary means in the name of fighting Obama advances any worthwhile policy goal.
If any of my Republican friends would care to break it down for me, I’ll buy you a $1.50 fried fish sandwich at Hoskins St. Seafood in High Point. That’s the best I can do.