Can someone give me a no shit realistic scenario of what happens if SCOTUS overturns ACA subsidies?

[Ex Lurker]

There have been plenty of threads venting about the Rethugs, etc, but I'm trying to do some planning about where to go from here, so I'd appreciate some actual nuts and bolts answers, or at least informed speculation.

Will the subsidies disappear overnight?
If so, will I be able to cancel my insurance without penalties, because no way in hell I can afford it without them?
Is there anything the Administration will be able to do through executive orders?
Is there any chance at all Congress may fix this? (I know, dream on, but might as well ask)
Anything else you might think of as well. TIA

[hlthe2b]

1. Well, the REPUBs, especially those on the Supreme Court won't care...

The administration will undoubtedly try to find some miraculous loophole to let them respond or at least "soften" the blow...

It is possible the sane members of the court might successfully argue a stay of any horrific decision just long enough to allow some response, but who knows?

[jeff47]

2. Some answers

Will the subsidies disappear overnight?

Depends on the exact wording of the decision.

If so, will I be able to cancel my insurance without penalties, because no way in hell I can afford it without them?

Depends on the wording of your contract with the insurance company. Most likely the insurance company will insist you pay. It is unlikely, but possible, that they could legally compel you to pay.

there any chance at all Congress may fix this? (I know, dream on, but might as well ask)

Yes, Republicans respond to massive rage from their constituents. So there's a chance that the not-quite-insane part of the party will realize they need to tweak the law or face annihilation. Similar to how they backed down from the government shutdown.

Additionally, it's not clear how much of a "state exchange" your state would have to set up - that will depend on the decision. It's quite possible that the "state exchange" could be a website that consists of a link to the federal exchange. Which would soothe the rage directed at state Republicans.

[Ex Lurker]

4. Well, I live in Louisiana, so that's out

Jindal won't lift a finger.

[belzabubba333]

5. this is wrong Yes, Republicans respond to massive rage from their constituents

wrong in the sense they respond because the cons fire up the base with what the cons want to change so their base starts screaming about stuff the cons already want to change. the cons dont "listen" to their base. their base rages at what the cons want them to rage against. their base wants jobs but the cons arent gonna produce any sort of jobs bill

[jeff47]

8. Which is why the government shutdown lasted for months and months and...

...oh wait it didn't.

[belzabubba333]

11. but you said" Yes, Republicans respond to massive rage from their constituents"

and their constituents WANTED the shutdown the fact that they didnt shut it down for months means the are NOT responding to their base. they wouldnt in this case b/c shutting it down is political suicide. youre contradicting yourself

[jeff47]

12. Their constituents are not just their base.

youre contradicting yourself

No, you're using the wrong definition of "constituent". For example, McConnell's constituents include all the Democrats who voted for Grimes. As well as all the Republicans who only voted for McConnell because he lied about KyNect being independent of Obamacare.

The Republicans are politically astute enough to go against their base when their insanity is backfiring.

[WillowTree]

14. Ins company cannot "compel" anyone to pay their premium.

If the premium isn't paid, the policy will lapse for non-payment.

Of course, then the no-longer-insured person will be on the hook for the penalty for not having insurance.

[jeff47]

15. Depends on the contract

They may be able so sue. It is unlikely they'd bother.

Of course, then the no-longer-insured person will be on the hook for the penalty for not having insurance.

Probably not. There's been no penalty for the people who should be covered by Medicaid in the states that refused to expand Medicaid.

[WillowTree]

16. There isn't an insurance contract in this Country that can in any way "compel" payment.

Again, if the insured entity doesn't pay the premium, they're just not covered.

[jeff47]

17. If the contract says you have to pay, they can sue you for violating the contract

Just like your credit card company can sue you for non-payment, or your landlord, or your mortgage company, or your car dealer or anyone else you sign a contract with.

The insurance company is not likely to bother, because it will cost too much and the likely recovery is too small.

[dsc]

22. those are different kinds of contracts

with the exception of the landlord the rest have provided you something for which you are paying them back (the car, the house, the stuff you bought with the credit card). In the case of the landlord they can make you sign a lease with a penalty for breaking it but they have to mitigate their damages by finding another renter. In most cases you are on the hook for only a couple of months which are actual damages to the landlord. The insurance company has no such issue. They pay your claims after you get seen and will know if you have insurance or not when you are seen.

[jeff47]

24. And the insurance company supplied you with insurance.

You and the insurance company signed a contract where they gave you something of value in return for you giving them money. Most likely, you agreed to keep paying them for some time period.

If you just stop paying, you've violated the contract and theoretically they could sue for you breaking the contract. Not gonna happen, since the insurance company would lose too much money on the lawsuit - the best they could gain would be a payment or two.

The most likely result would be the insurance company just cancels the policy and stops paying claims. And sends you some angry letters and phone calls saying "You have to pay!!!!".

[dsc]

27. they provided you insurance for the time you were insured

but once you stop paying, you aren't insured anymore. If your interpretation of contract law was valid then when employees lost their jobs the company would be on the hook for their part of the insurance for the rest of the year, which they most assuredly are not.

[jeff47]

31. Depends if it's pre-pay or post-pay.

I can get insurance coverage before I send in a check. Which means I've received something of value before paying them money.

If your interpretation of contract law was valid then when employees lost their jobs the company would be on the hook for their part of the insurance for the rest of the year

And the ability to drop people for no longer working at the company is explicitly covered in the contract between the company and the insurer.

[WillowTree]

38. And the insurance co. has the ability to discontinue your insurance........

.......as of the date through which your premiums have been paid. That's covered in that contract. If you never pay, they'll cancel your coverage back to the effective date. If you don't pay an installment, they'll cancel it as of the date through which your premiums have been paid. End of story.

Those are the facts and I do know what I'm talking about. You're obviously invested in believing that an insurance contract can compel you to pay the premiums and aren't interested in how it really works, so I'm finished explaining it.

Have a nice evening.

[WillowTree]

36. No, you don't post-pay for insurance.

You pay for insurance in advance. No payment, no coverage. And that's the end of it.

Believe what you want. You obviously will. But that is the way it works.

[WillowTree]

35. No, they'll cancel the policy.

The difference is that the charges on your credit card is for items that you've already bought and paid for with the card and the cc company has, in turn, paid whomever you purchased goods or services from. They're already "out" the money and you have to pay it back to them.

If you don't pay an insurance premium, they cancel the policy and you don't have coverage so they won't pay any charges. Unlike your credit card company or landlord or mortgage holder or auto finance company, they haven't "advanced" anything to you. You're paying in advance, not paying for something you've already received and used.

Please believe me, they can't force you to pay and there's nothing in the contract that compels premium payment. The only small chance of them coming after you is if there was somehow a delay in the cancellation for non-payment and they inadvertently paid a claim incurred after the "paid-thru-date". In that case, you would be required to reimburse them for the amount paid in error and yes, they will come after you for that.

[HereSince1628]

18. And the penalty will cause anger at that 'hated' mandate

which is pretty much what the r's want their constituents to feel

[jeff47]

26. No, the penalty has not been enforced when people should have been

covered by Medicaid expansion. It's not likely that the penalty would be enforced in states where the subsidies were canceled.

[Skink]

29. I set up my premium payment

For a penny as an auto dedection. Could the subsidy if not paid be applied here?

[quadrature]

39. what exactly is an 'exchange'?

a room
desk
phone hookup
a www hotlink
has to be in the state it serves
has to be an act of the state legislature

some or all of the above?????
does an exchange keep any records?
does 'it' have any obligations?

[4139]

3. It may depend on your state, WashPost this afternoon...

http://www.washingtonpost.com/blogs/wonkblog/wp/2014/11/11/how-states-could-avert-a-supreme-court-obamacare-disaster/

[Live and Learn]

7. +1 It will greatly limit the states in which people that want affordable

health care can live.

[haele]

6. Red States citizens get screwed. President gets trashed, threatened with impeachment.

1) Robert's court strikes down the subsidies. Those subsidies mean nothing to the Insurance Industry, who has a captive consumer base because of the mandate, so that's not something that needs to be considered by the Fanatic Five.
Striking down the subsidies, however, fit into "balancing the budget, etc" focus of the Holy Elect of Governemnt and Business - as spending tax money on people who can't afford to Lobby Congress or get an appeal up high enough to be heard by the Supreme Court without using a government provided lawyer is a sin against both St. Ayn the Neo-Liberal Conservitive, and the Evangelical Church of Mammon (John Birch Synod) and thus cannot be allowed.

2) GOP Congress sits on its collective assess waiting for the President to be forced to do something to salvage as much of the ACA as he can.

3) When the President tries to do something, they jump up and down and play gotcha games, Issa does another investigation wasting millions if not billions of dollars, and nothing gets done, because the Senate still does not have enough Tea Partiers to push impeachment through.

And in the meantime, those Red State citizens who were depending on federal subsidies to at least soften the blow that their "Fiscally Concerned" Governers are beating them with by not setting up health exchanges and dealing with the businesses who throw lots of money at them to be able to set whatever prices they want are going to pay and pay and pay until it hurts enough they can be carted off to debtor's prisons. Well, as soon as the Supreme Court indicates that States can set up Debtor's Prisons because not paying your bills is like stealing from the Corporations who steal from you so they can sue you and the State lock you up in a for-profit prison complex until you work off enough to pay your outstanding medical bills and required premium payments as well as the money it takes to pay for your upkeep - and it's not indentured servitude, so stop saying it is!

Well, the Debtor's Prison for medical debts is probably not going to happen any time soon, but I'd be willing to bet the first three will.

Haele

[wandy]

20. Excellent assessment.

[dsc]

25. the subsides mean a great deal to the industry

no healthy person is going to pay full price for insurance without the subsidy. the penalty is at most 1/6 the cost of the insurance for those people and they aren't going to pay for a product they don't use if paying for it will put a serious crimp in their standard of living. A person making 25k a year would pay a 500 penalty for the entire year, while the insurance would surely be over 250 a month. As healthy people drop out, the premiums will rise causing more people to drop out, causing premiums to rise and so on. Soon the individual market will be dead in those states.

[MFM008]

41. Prez and democrats

always should have had some sort of back up plan for ACA, they should have KNOWN this type of challenge was coming down the pipes at some point, people should not have to worry about every single case the SC takes will destroy their lives, which is just what repukes are all about.

[lumberjack_jeff]

9. How far down the rabbit hole should we go?

If the court finds that the intent of the ACA was to deny subsidies to people who use the federal exchange, then it seems to me that the ACA itself is fundamentally violative of the equal protection clause of the 14th amendment.

The least ridiculous interpretation is that the federal exchange is supposed to be a proxy for the state exchanges.

[sweetapogee]

10. Since the authors of the law didn't anticipate that

the subsidies would be deemed illegal, there isn't to my knowledge any provision to allow anyone to cancel without the non-insured penalty. It is hard to know how fast the subsidies would disappear, however, a better question to ask is what about the credits already granted? Since there wouldn't be any way for the government or the insurance provider to collect the funds, what happens to all that debt? And now we hear that they are projecting less than anticipated new enrollees into the program this year. Not good.

What would an executive order to fix the problem look like? Good question. And what would be the motivation for the new congress to address the problem? I know that a lot of people here want the President to breath fire down on the pukes but take a step back and really digest the midterms and their implications. Vile as the pukes are they happen to be in a great position to get their way on practically everything we want. Sorry if this offends.

Perhaps the SC will let the subsidies stand although if they did, it would still be on the administration to suggest a work around and congress to implement it because the money has to come from somewhere. The Democratic leadership should consider formulating a contingency plan (or plans) to address the situation regardless of how the SC acts. Be proactive. Sometimes you have to do things that you find distasteful to get what you want. But in the end, look who gets hurt.

[hughee99]

13. First thing is, I'll die of shock if the SC rules that the government CAN'T give subsidies

to private healthcare companies. This was the whole reason the law was able to pass in the first place.

[Hoyt]

19. That, and intent of the law is clear. I think subsidies in states using federal exchange are safe.

[subterranean]

21. We can only speculate, but...

I think what might happen is that the Repukes will agree to fix the problematic clause only if they can make other changes to the law, such as adding some sort of tort reform, repealing the tax on medical equipment and changing the definition of "full-time" from 30 to 40 hours, which they've already said they want to do. That's my guess.

[CK_John]

23. IMO, the court ruling should only effect the fed subsidies in states that did not extend

Medicaid programs, the old states right argument to screw their citizens.

Nobody can give you answer not even the Chief Justice on how they will rule and the behind the scene pressures from fortune 500 companies to not create chaos and the rest of the world trying to create chaos.

[still_one]

30. That is true, but a lot of folks in red states will be hurt

[still_one]

28. If you are in California you will be fine. If you are in a re thug state you are screwed

[Skink]

32. The way I see it

In the red state of Texas we will quickly set up an exchange. In order to atract businesses from other states we need heathcare. Texas is growing faster than any other state but refuses to expand medicaid.

[Ex Lurker]

33. as I stated upthread, I'm in Louisiana

I'll be shocked beyond measure if Jindal does anything to help.

[Skink]

34. Texas is growing at the expense of Luisiana et al

[Manifestor_of_Light]

37. They expected all the states to set up their own programs.

However, the red states are screwed because they refuse to set up programs with subsidies and as someone noted above, I think that that difference violates the equal protection clause of the 14th Amendment.

I don't think the Supremes could compel the red states to set up an exchange.

[drray23]

40. this may be a case

Where the huge influence lobbyists have on congress and i daresay the scotus may be to our advantage.

The health care industry has invested billions to adopt the ACA. They are making money from it and would not want to deal with the costly and logistical nightmare of reverting back to pre ACA.

What i think will happen is that the scotus will uphold it perhaps directing congress to fix the ambiguous language, repubs will take potshots at the ACA tweaking minor aspects of it but wont be able to repeal it.

[customerserviceguy]

42. It would be utter chaos

And the Repukes would take full advantage of that chaos to craft their own revised version of the ACA. Of course, getting them to agree on something to deal with that crisis would be tough, but if they could put it together, the President would be faced with the choice of signing it, and preserving some shred of his legacy, or watching the whole thing go down the toilet.

My guess is that we'll have a clue as to what he will do by the time that a negative SCOTUS decision would arrive. It's possible that Kennedy would side with the progressives just to avoid the chaos.

[pnwmom]

44. It's Roberts whose vote is unlikely and we would need. nt

[pnwmom]

43. Will you "be able to cancel" your insurance? I'd worry more about not having any.

But, yes, without the subsidies, you could cancel because no one is subject to a penalty if the insurance is unaffordable -- as yours would be without the subsidies.

[Ex Lurker]

45. Well sure, that goes without saying

of course I want to keep my insurance, but if it's between that and paying the rent, something has to give.