King v. Burwell: What Republicans Are Really Hoping For

No matter how many repeal votes or legal runarounds are pursued, the Affordable Care Act is the law of the land and it is improving the lives of millions of Americans who now have affordable access to health insurance.
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Some Republicans are gleefully anticipating that the Supreme Court might deal a big blow to the Affordable Care Act when it rules in the King v. Burwell case, which is being argued before the Court Wednesday.

The plaintiffs in this case, and the many Republicans in Congress who are cheering them on, want to eliminate the current tax credits that enable millions of Americans of modest means to buy health insurance.

Let's think about what those rooting for a 5-4 decision by the Supreme Court conservatives are actually hoping for.

They're hoping to cost about seven million Americans an average of $3,164 per year.

They're hoping to cause health insurance premiums for those Americans to rise by an average of 322 percent -- in other words, for cost to more than quadruple.

In short, the outcome they're hoping for means dire financial consequences for millions of middle-class families -- an outcome that, for many, could cause them to lose their health insurance entirely because it simply wouldn't be feasible for them to afford it anymore.

Regardless of one's views on the Affordable Care Act, we should all be able to agree that premium increases of over 300 percent are bad for American middle-class families. After all, Republicans and Democrats alike have spent years railing against big premium hikes, and Republicans in particular have expressed grave concern about potential premium increases in recent years.

Are Republicans now in favor of a tripling of health insurance premiums? Is the ability of families to keep health plans they currently have no longer important?

Republican opposition to the Affordable Care Act long ago stopped being a policy position so much as a dogma. It's time for Republicans to own up to what their fixation on destroying the Affordable Care Act will really mean to millions of their constituents.

For people with pre-existing conditions who today have some peace of mind thanks to insurance, for parents of kids with asthma who can have an inhaler on hand thanks to insurance, for all of those who have enough money in their pockets now to save for the future or buy new shoes for school or get the car fixed, the Affordable Care Act is about a lot more than ideology and politics.

And it would be a supremely political decision to strike down the tax credits in states with federally-run health insurance exchanges, as the plaintiffs are asking the Court to do.

To anyone who even remotely followed the debate over the health care law while it was being drafted, debated and passed, their argument is ludicrous.

As a Senator who was a member of the Senate Health, Education, Labor and Pensions Committee at the time the law was debated and passed, I can state unequivocally that our intention was to make tax credits to help buy health insurance available to Americans in all states, regardless of whether the state or federal government operated the exchange. Moreover, the language in the statute, when read in the full context, is crystal clear. If a state chooses not to operate an exchange, the federal government will come in and operate an exchange on behalf of the state.

The non-partisan policy experts at the Congressional Budget Office, who carefully reviewed the bill to provide expert analysis on its cost, never even contemplated the possibility that tax credits might not be available to Americans in all 50 states.

The law is perfectly clear -- to anyone who is not willfully trying to misinterpret it -- that tax credits were intended for anyone who qualified, in all states. It would take politically motivated judicial contortions to conclude otherwise.

Nevertheless, many Republicans are hoping the Supreme Court will embrace this absurd legal position because they see it as a body blow to the Affordable Care Act. In their eyes, it is the chance to finally achieve through the courts what their 56-and-counting votes to repeal Obamacare have not.

The Affordable Care Act is not perfect. No law in our nation's history has ever been perfect or beyond scrutiny. But this piece of the law is not in question. We named it the "Affordable Care Act" for a reason -- because we fully intended the law to make health insurance affordable to Americans in all 50 states, and wrote the law as such.

No matter how many repeal votes or legal runarounds are pursued, the Affordable Care Act is the law of the land and it is improving the lives of millions of Americans who now have affordable access to health insurance.

To those trying to upend the law: real lives are on the line. Enough is enough.

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