GOP’s ‘Plan B’ to Affordable Care Act a major step backwards

Sen. Orin Hatch (R-UT) say he has a “Plan B” in case the U.S. Supreme Court rules against the Affordable Care Act in King v. Burwell (wink, wink). The Hill reports, Senator to unveil plan B for ObamaCare:

The Republican chairman of the Senate Finance Committee on Monday said he will release a backup plan for ObamaCare in case the Supreme Court rules against the law this summer.

Sen. Orrin Hatch (R-Utah) said he has been crafting a “solution for those Americans who may be affected” by the looming King v. Burwell case, which threatens to end healthcare subsidies for people living in 37 states.

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Hatch’s announcement of an ObamaCare “backup plan” comes about two weeks after he and two other top Republicans unveiled what they called an ObamaCare replacement plan, though few conservatives rallied around it.

That’s because Tea-Publicans do not want an alternative to the Affordable Care Act. They want to return to the broken healthcare system which was far worse than any problems people have experienced with the implementation of “ObamaCare.” For Tens of Millions, Obamacare Is Working.

Sen. Hatch’s so-called “Plan B” is a major step backwards as well. Andrea Flynn, a fellow at the Roosevelt Institute, writes at The Hill, GOP health plan would leave many low-income families behind:

Republican Sens. Richard Burr (N.C.) and Orrin Hatch (Utah) and Rep. Fred Upton (Mich.) recently released one such plan that they hope to build upon the ashes of ACA, which they and their conservative colleagues have tried mightily to burn to the ground. Their proposal — the Patient Choice, Affordability, Responsibility and Empowerment Act, or the Patient CARE Act (PCA) — raises more questions than it answers, but it is clear that the plan would be a step backwards for many low-income U.S. families that have benefitted from the ACA.

Republicans would like for us to think that the ACA has been a dismal failure that has done more harm than good. And it would be fair if you believed that, given the more than 50 times they have voted to repeal the law and their relentless efforts to thwart some of the its most significant provisions. Is it really possible for something that is actually helping people to stoke such intense hatred? Indeed, it is.

The ACA is far from perfect. But it is a significant improvement over the tearing-at-the-seams patchwork quilt that predated it. How quickly we forget that before the ACA, people were routinely denied insurance based on preexisting conditions (like having given birth). Women were charged higher premiums than men just because they were women. Individuals with insurance often didn’t seek out preventive care because of high co-pays. Uninsured young people wished away illnesses because they couldn’t afford the out-of-pocket cost of visiting a doctor. And lots of women didn’t use birth control because they simply couldn’t afford it. The ACA solved these problems for millions of people.

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What would the PCA mean for everyone who has gained insurance? Well, from starting gate, they would likely need to find new coverage because it would repeal the ACA in its entirety. In doing so, it would eliminate Medicaid expansion, the health exchanges, tax credits and the ACA’s cost-sharing reductions.

According to the Center for Budget and Policy Priorities — which evaluated the first iteration of this plan in May — that’s just the beginning. Under the PCA, a number of individuals who currently enjoy premium tax credits under the ACA would no longer qualify, including legal immigrants and people with incomes above 300 percent of the federal poverty level (currently individuals with incomes up to 400 percent qualify for tax credits). The older among us could be charged five times as much — or more — than younger people, and their tax credits would be much lower. There are fewer protections for customers with preexisting conditions and patients would likely pay more for deductibles and co-payments. Insurance plans would likely not be required to include the comprehensive host of benefits guaranteed by the ACA.

The plan would likely leave states with inadequate funding for Medicaid, forcing them to increase their own spending or make cutbacks to programs that low-income families rely on. Insurance companies could set annual coverage limits, could lift caps on out-of-pocket expenses and could charge women more than men. States would have the freedom to determine whether or not young people under 26 can get coverage through their parents’ health policies. The new plan would be a rollback, not progress.

We are also seeing a rift develop in the GOP between the ideologue Red States that simply want to destroy the Affordable Care Act, and those Republican governors whose states have financially benefited from the ACA — they want a real “Plan B” in the event the U.S. Supreme Court rules against the ACA. The Washington Post reported, Republican governors worry about fate of Obamacare subsidies:

Governors in states across the country have begun pressuring Congressional leaders and making contingency plans in case the Supreme Court decides that millions of people who get subsidies to pay for health care under the Affordable Care Act are unconstitutional.

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Governors of 34 states, even the Republicans who oppose the Affordable Care Act, say they are concerned at the chaos that could ensue if the court rules the federal subsidies unconstitutional. While no solution is evident, they are using a meeting of the National Governors Association, happening this weekend at a Washington hotel, to discuss contingency plans.

“It has been the topic of the day. I mean it is what all governors are talking about,” said South Carolina Gov. Nikki Haley (R), who leads a state in which 172,000 people qualify for federal subsidies. “You’re going to hear the governors be very loud about this.”

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About 87 percent of those who live in the 34 states that opted not to create their own exchanges qualify for subsidies, according to the Department of Health and Human Services. The average subsidy is $268 a month, which lowers premiums by 72 percent. An Urban Institute study found that 61 percent of those who receive federal subsidies are non-Hispanic whites, and 62 percent live in the South. More than 80 percent work full or part-time.

Utah Gov. Gary Herbert (R) has already spoken to Senate Majority Leader Mitch McConnell and House Speaker John Boehner, he said in an interview. But, he added, there is uncertainty over what path the Supreme Court might choose to take — and whether their ultimate decision would take effect immediately.

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Republican discomfort with the possible fallout from King v. Burwell is evident in court filings, or the lack thereof. While Republican governors have raced to challenge the Affordable Care Act in other facets, only seven states — Alabama, Georgia, Indiana, Nebraska, Oklahoma, South Carolina and West Virginia — have filed briefs arguing the federal subsidies are illegal.

Without the federal subsidies, states could choose to rush to implement their own marketplaces. But establishing those marketplaces have been challenging, even in states where the political will exists: Oregon, New Mexico and Nevada have all scrapped their own marketplaces and opted into the federal HealthCare.gov system after technical problems hindered sign-ups.

In other states, mostly those dominated by Republican legislatures and governors, the political will to create a state exchange — and, thus, to appear to opt in to Obamacare — doesn’t exist [e.g. Arizona].

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Republicans control the legislature or the governor’s mansion in 33 of the 34 states that opted not to pursue their own exchanges — the lone exception being Delaware. In those states, where the political will to create health-care exchanges does not exist, governors will put pressure on their Congressional delegations to pass a fix.

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But Congressional action is unlikely. Though Republicans, such as Louisiana Gov. Bobby Jindal (R), Sens. Richard Burr (R-N.C.) and Orrin Hatch (R-Utah), and Rep. Fred Upton (R-Mich.), have proposed alternatives to the Affordable Care Act, achieving the 60 votes necessary to advance a bill in the Senate, where Democrats still have 46 votes, looms as a major hurdle. And the odds President Obama would sign anything that threatens his signature legislative accomplishment are slim, if not nonexistent.

“There’s no B plan by either the federal government or the states,” said North Carolina Gov. Pat McCrory (R).

The simple solution is for the U.S. Supreme Court to reject what is now clear to every objective observer to be a fraud upon the Court by the Libertarian lawyers who brought this politically motivated lawsuit. At least four of the Justices voted to go along with this scheme in granting this appeal before the full D.C. Circuit Court of Appeals could hear the appeal en banc, so it will come down to Chief Justice John Roberts once again.