Category Archives: King v. Burwell

Sarah Kliff’s Recycled Mess

Among the many recently trotting out heart-breaking tales of woe — to shamelessly pressure the Supreme Court in King v. Burwell — is Sarah Kliff, with a piece titled:

“The Supreme Court’s Obamacare decision will determine
if this cancer patient gets chemotherapy.”

You can be forgiven for not having seen the article. In fact, our crack research team almost missed it. It was published on June 12 in an outlet called Vox, led by America’s alleged wunderkind and intellectual giant Ezra Klein. 

Vox is a site hosting writers who enjoy referring to themselves as “wonks” and “nerds” because it makes them sound brighter than they really are. Actually, they’re just partisans.

Lefties like these are growing increasingly nervous as Decision Day draws near in King v. Burwell. Perhaps that’s why Kliff re-ran her story of Marilyn Schramm, which she first posted — with the same title — on February 26, 2015. 

One wonders why she couldn’t locate another anecdote.

Here’s what Kliff wrote, in both pieces:

Marilyn Schramm is thinking about moving. She is a 63-year-old retiree who lives in Texas, and since November 2013 she’s purchased health insurance through Healthcare.gov. She has a policy that costs about $800 per month. Schramm, who earns $28,000 from her pension, pays about half the cost, and the federal government covers the rest with a subsidy.

Her best back-up plan right now, she says,
is moving to a place with a state-run exchange.

(emphasis added)

We’ll refer you to John Sexton of Breitbart to give you his take on Kliff’s first post. 

We’ll also add that Ms. Schramm appears to be an attorney who retired from the Texas state government in 2010 and started her own consultancy business in 2011.

And Kliff doesn’t tell us why Ms. Schramm had to sign up with Healthcare.gov. Was she one of the millions whose coverage was canceled in late 2013? Kliff conveniently omits those details.

What’s more important is that Ms. Schramm, and everyone else in her position, receive some sound financial advice. 

Kliff could have been trying to antagonize the Justices when noting Ms. Schramm may choose to relocate, but she inadvertently described a solution for Americans in Healthcare.gov states. 

Yes, Ms. Schramm, you can — and should — move to a state with its own Obamacare exchange. It’s only logical.

Think about it. Older Americans migrate to certain states to avoid taxes on pension benefits and estates. Some move to states with lower income taxes, while others favor states with minimal property taxes. 

Americans rightly gravitate to states that meet their personal needs. Even on a local level, undocumented immigrants are attracted to sanctuary cities.

So if the King plaintiffs prevail, Americans in states with federally-established exchanges won’t really lose taxpayer subsidies. They can still receive them — in the Progressive states who will welcome them with open arms. 

Those states can be referred to as Medical Sanctuary States (or MeSSes).

Keynesian theorists understand that states with greater public spending promote economic growth. And, as our national treasure Jonathan Gruber explains, Progressive states, since they also embrace the expansion of Medicaid, will experience a major economic stimulus from the influx of federal dollars. 

In other words, the MeSSes will economically thrive!

And it just keeps getting better. Liberal voters, eager for Obamacare subsidies, Medicaid, and other government benefits, should flood these MeSSes, thereby tipping census figures in those states and changing the numbers in the House, Senate, and Electoral College. 

They’ll also overtake Conservatives in their state legislatures, improving state economies further through mandated minimum wages, higher state income, sales, and inheritance taxes, and other socially Progressive policies.

The best part? As Gruber notes, Conservative states will be paying federal taxes for the perks available in the MeSSes, thus accelerating the redistribution of wealth.

Given these obvious results, Progressives should cheer if the Obama administration is defeated in King v. Burwell. They just don’t realize this due to their basic “lack of economic understanding.”

Hmm. In originating the Obamacare subsidies cases, including King, what were Michael Cannon and Jonathan Adler thinking? Are they really just Progressives in sheep’s clothing? (Snark intended.)

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April Fools’ Bracket: Who Wins? The Cannon or The Gruber?

Financial services company Sun Life is again hosting its Wake Up Summit. Its last webinar explored the effect of Obamacare on the nation, and Jonathan Gruber, MIT economist and Obamacare architect, was a speaker in the keynote address and a contributor to one panel discussion (registration required to view). 

The conference could have been described as boringly collegial.

This year’s webinar occurs on April Fools’ Day and may prove more provocative. Wake Up Summit 2015 will again feature Jonathan Gruber, but this time alongside Michael Cannon, the Cato Institute’s director of health policy studies and, with legal scholar Jonathan Adler, one of the masterminds of the so-called Obamacare “subsidies cases.” The informed reader will recall King v. Burwell as the case most recently heard at the Supreme Court.

If you’re free at 2:00 p.m. on Wednesday, you can register to watch it live here. Click the RSVP button on the right side of the page.

You can also make the event more lively. Sun Life is inviting questions before the event. 

You may have a variety of questions of your own for Mr. Gruber. But you could also pose questions like these, for either participant:

1. Everyone’s heard that “if you like your plan, you can keep your plan.” Would you please explain how the ACA affects those who receive health insurance from their employers?”
2. When Senator Obama ran for office he promised not to eliminate the tax exclusion for job-based insurance. But doesn’t the Cadillac Tax achieve the same goal over an extended time frame?

3. Don’t you think the Cadillac Tax is mislabeled since it appears to eventually impact most if not all job-based plans?
4. Why does the Cadillac Tax cap grow at CPI or CPI +1? Won’t that assure that most if not all plans become Cadillac Tax plans?
5. What do you think of S&P Capitals’ recent prediction that by 2020 90% of those with job-based coverage will be shifted to the ACA exchanges?
6. Do you agree with Medicare chief actuary Richard Foster’s prediction that “essentially all Americans” will over time get their private coverage through ACA exchanges?
7. Exactly how does the ACA cause “wage growth” for workers?
8. The CBO scores the ACA as improving the deficit more in the out years than in the first ten years. Why is that?
9. Do you think the ACA is more like Romneycare or Hillarycare?
10. If states do not establish their own exchanges, what role do states really have with regard to the ACA?
11. Is a “single payer“ health system more likely if the ACA fails or if the ACA succeeds?

Of course, you’re also free to ask not-so-serious questions of either Mr. Gruber or Mr. Cannon, questions like these:

1. Why aren’t you, Mr. Gruber, still hiding under a rock?
2. Are you, Mr. Gruber, capable of feeling shame?

3. Mr. Gruber, would you like to clarify your “falling off a building” prediction for workers losing job-based insurance?
4. Mr. Gruber, why were your Obamacare models so wrong?
5. Have you, Mr. Gruber, apologized to your family for publicly humiliating them?
6. Has MIT placed any sanctions on you, Mr. Gruber, given your damaging effects on its reputation?
7. Mr. Gruber, when will you turn over your “research assistants’” records?
8. Mr. Cannon, how did you become so flipping awesome?

Feel free to offer your questions in the comments section below. But it’s far more important that you send them to Sun Life.

Of course, as Mr. Cannon points out, Mr. Gruber may not show up at all. 

Research on Past Health Reform Efforts Yields a Slam-Dunk for King v. Burwell Plaintiffs

The stakes are awfully high in the SCOTUS King v. Burwell ruling, to be announced later this spring.

If the Supreme Court decides the administration illegally extended Obamacare subsidies to those enrolled through Healthcare.gov, many Americans will lose the financial aid they were promised and find health insurance coverage unaffordable.

[By the way, this begs a few questions: Why is the government mandating that Americans buy individual policies that are, on average, 49% more expensive than they were pre-Obamacare — after scheming to throw millions of Americans off their old policies? Aided by the over 500,000 health insurance agents in the country, aren’t we capable of finding insurance that meets our particular needs? Or are we just too stupid to know what’s good for us?]

On the other hand, a ruling for the plaintiffs would release 57 million Americans from mandates to which the law, as written, did not subject them. Employers in most states could relax about the law’s potentially huge blow to their financial health, countless Americans would no longer fret about dealing with IRS employees tasked to oversee their premium payments, and state economies could improve.

A most stunning and disappointing episode in U.S. politics is revealing itself, as Congressional Democrats are now forced to admit they didn’t read the fundamentally transformative bill for which they voted in 2009 and 2010. Pro-government amicus briefs assert that Congress never intended — or worse yet, understood — that premium subsidies were restricted to state-established exchanges, despite the law’s clear language.

It’s as if they’re saying, “Never mind what we voted for! What’s important is what we thought we were voting for!”

Would that work with your mortgage? Would a bank allow you to unilaterally change the terms of your home loan because you didn’t read — or understand — the contract you signed? That’s the federal government’s position here.

And are Congressional Democrats telling us the truth about their intentions in 2009 and 2010? Remember: these are the very same people who repeatedly assured us we could keep our plans and our doctors.

The administration maintains that it’s well within its bounds to rewrite Obamacare. It also says it would have been “perverse” for Congress to pressure states to cooperate with the sweeping law by holding premium subsidies over their heads.

Thanks to a great deal of health reform research, we know this kind of perversity has endured through over four decades of proposals, from Nixon, through Clinton, and through subsequent plans.

This Forbes analysis gives the details, but here’s the takeaway: Given the history of U.S. health reform efforts, it’s looking likely the King plaintiffs are correct in claiming Obamacare drafters aimed to punish refusenik states. In fact, after digesting this research, we may legitimately ask, why wouldn’t they?

The Role of Timothy Jost in Obamacare’s “King” Problem

No one — outside an inner circle of Obama advisors — knows who snuck those four little words, “established by the state,” into Obamacare when it was being crafted. Nobody’s owning up.

But at least one person was writing about withholding subsidies in non-cooperative states while the bill was being created.

In a 2009 paper titled “Health Insurance Exchanges: Legal Issues,” Professor Jost proposed options for creating health insurance exchanges under national health care reform. And he obviously didn’t believe the second option was unconstitutionally coercive

Congress might attempt to implement a federal exchange program through the states, thus taking advantage of the insurance regulation institutions and experience of the states. In doing so, it would need to be mindful of the limitations the Constitution places on the power of the federal government to control the states. The Constitution has been interpreted to preclude Congress from passing laws that “commandeer” the authority of the states for federal regulatory purposes. That is, Congress cannot require the states to participate in a federal insurance exchange program by simple fiat. This limitation, however, would not necessarily block Congress from establishing insurance exchanges. Congress could invite state participation in a federal program, and provide a federal fallback program to administer exchanges in states that refused to establish complying exchanges. Alternatively it could exercise its Constitutional authority to spend money for the public welfare (the “spending power”), either by offering tax subsidies for insurance only in states that complied with federal requirements (as it has done with respect to tax subsidies for health savings accounts) or by offering explicit payments to states that establish exchanges conforming to federal requirements.
As it turned out, the Obamacare Congress used all three mechanisms to force state cooperation. But, again, no one’s being forthcoming about the author(s) of the restrictive subsidy language. Apparently the Obamacare Congress thinks this secret is not the business of the American people.