Peggy Salvatore hosted the Valentine’s Day edition of the Health Wonk Review, and you don’t want to miss it. Here are some of my favorites in this week’s HWR:
Writing at Health Affairs, Ron Pollack from Families USA demonstrates the ways that the context of the ACA clearly makes subsidies available in every state. SCOTUS is scheduled to hear King v. Burwell in just a few weeks, and we’ll have a ruling by June. It won’t impact us here in Colorado, because we’ve got a state-run exchange. But for millions of Americans in the 34 states with HHS-run exchanges, a lot hangs in the balance of that SCOTUS ruling. I’ve always believed that the language “exchange established by the state” was used to clarify that subsidies would only be available in the official ACA-created exchange, as opposed to private exchanges and hot messes like Florida’s discount plan exchange (although that’s technically established by the state… I wonder what the King plaintiffs make of that one?). It’s baffling that there’s actually a case – about to be heard by the Supreme Court – that claims that subsidies are only available in 16 states and DC. Ron’s article is clear reminder that Congress obviously intended subsidies to apply nationwide, and that the Supreme Court has already clarified in 2012 that they understand the importance of those subsidies as the mechanism for making health insurance affordable.
Joe Paduda gives us a reality check to counter all the talk radio anti-ACA propaganda that tends to blame every problem – real or perceived – with our healthcare system on Obamacare. Joe reminds us that many of the problems predate the ACA by a wide margin, and that many of them are also starting to get better under the ACA. Lots of good stuff in this article.
Maggie Mahar explains everything you need to know about the shared responsibility provision (aka individual mandate), the penalty, and the exemptions that are available for many uninsured Americans. I agree that the most important exemption is the one for people in the coverage gap in states that haven’t expanded Medicaid – those individuals truly have no realistic access to health insurance. But as Maggie says, many of the people who qualify for exemptions also qualify for either Medicaid or significant subsidies that make health insurance truly affordable. It’s a far better option to take the carrot than the stick! Overall, the mandate is still very much in force, and additional documentation will be used to further enforce it for 2015. Andrew Sprung and I recently discussed the mandate and the penalty in this video, so if you have more questions, check it out.
There are plenty of other great articles in the HWR this week. Enjoy, and Happy Valentine’s Day!