The GOP’s war on healthcare


Q. What’s the difference between a Ukrainian rebel with a rocket launcher and a lawyer challenging the Obamacare subsidies?

A. The Ukrainian doesn’t intend to hurt innocent people.

So says Andre Koppelman at the Balkinization blog and The New Republic about the GOP’s war on healthcare. Obamacare Opponents Are Hurting 4.5 Million Workers to Win a Political War:

EthicsThe legal argument against the subsidies is weak on the merits.  But merits aside, the case raises important questions about the ethics of political warfare. When is it acceptable to deliberately aim to harm huge numbers of people in order to score a symbolic point? The point here is to discredit Obamacare; the casualties are simply a means to that end.

Here’s what the case is about. The Affordable Care Act (ACA) offers health insurance subsidies for Americans who make up to 400 percent of the poverty line. That means a single person whose income is up to $45,960, or a family of four with an income up to $94,200. Two sentences in the 2,700-page law say that the subsidy is available for insurance bought “through an exchange established by the state.” However, 36 states have decided not to open exchanges. The law provides that, when that happens, the federal government can open exchanges in their placeand it has done that.

The current round of lawsuits claim that no subsidies can be given to anyone who lives in one of those states, because they would not be buying “through an exchange established by the state.”

If the argument is ultimately accepted by the Supreme Court, then about 4.5 million low- and middle-income workers in those states who are already receiving assistance from Obamacare will abruptly lose their benefitsnot because they did anything wrong, but because this destruction furthers the political war. Their personal disasters are not unintended side effects of the litigation, but the very goal that the challengers are seeking.

This reading of the statute makes no sense. Courts don’t read provisions in isolation. Here are a couple of boring, standard rules of statutory interpretation: don’t take phrases out of context; try to make sense of the law as a whole. The ACA’s purpose was universal coverage. Other provisions declare that, when a state declines to establish an exchange, the federal government “shall” step in and establish and run “such” exchange, with the same authorities and obligations as a state-run exchange. That most sensibly means that the federal government is to act as if it were the state, and that the federally run exchange is to be the functional equivalent of a state exchange.

Outside the courts, the challengers have crowed that their argument, if accepted, would gut the law: People can’t get insurance if they can’t afford it, and their suit would make insurance unaffordable to millions. But ambiguous statutes are supposed to be read in ways that further, rather than thwart, their central purpose. Judge Harry Edwards, dissenting in the D.C. Circuit, observed that the majority’s interpretation “defies the will of Congress.”

That’s why the courts should reject these claims. Courts know how to make sense of drafting glitches.

It is known as the Chevron Deference. The U.S. Supreme Court held that courts should defer to agency interpretations of statutes unless they are unreasonable. It is one of  the most important principals in administrative law, established by the U.S. Supreme Court in Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (1984).

The challengers, understanding the weirdness of their reading, have claimed that this destructive result is just what Congress intended. There are provisions in the ACA, including big financial subsidies, to encourage states to set up their own exchanges. Jonathan Adler* and Michael Cannon, the authors of the challenge, write that “limiting the availability of tax credits to insurance purchased in state-run Exchanges can be seen as just one more inducement for state cooperation: the [Patient Protection and Affordable Care Act] threatens states with the loss of tax credits for state residents if they do not create an Exchange.”

But there’s not a word of the legislative history that indicates that this is what Congress meant. A threat is meaningless unless it is communicated. This supposed threat was unheard of until the law’s opponents dreamed it up, years after the law was enacted. The D.C. Circuit’s endorsement of this argument is judicial lawmaking in its worst form, reading a law to do the opposite of what was intended.

But enough about the judges. Focus on the litigatorspeople who have opposed Obamacare from the beginning, and who are now trying to sabotage it in any way they can, even if there is no likelihood that it will produce a political result that they find more palatable. I’ve spoken to some of these lawyers, and they argue that, whatever the value of the subsidies for all the low-income people who depend on them for medical care, the rule of law demands that their reading of the statute be followed. This is an odd version of the rule of law: The legislative scheme has to be distorted on the basis of a clever argument that was invented out of whole cloth by these same lawyers. The chaos that would follow their victory probably would not be good for the Republican party. It would be a disaster for the judiciary, which is why the suit is likely to be ultimately rejected by the courts. Many people, right now, are getting diabetes and cancer treatment through the subsidies that this litigation aims to terminate. An ethical person would think about those consequences before bringing a case whose ultimate purpose is merely to harass one’s political adversaries.

* * *

The decision of these lawyers to seize on this particular case is an extreme example of a moral dysfunction that has become a pervasive part of this particular political fight. The issue isn’t the ethics of lawyering; it’s the ethics of political combat. Harm to noncombatants is sometimes an unintended collateral consequences, but there’s no excuse for deliberately bringing it about.

The opponents of Obamacare have from the beginning found themselves driven by the logic of their position to make arguments that are increasingly morally repulsive. This was on display in the Supreme Court argument in March 2012. The government argued that the state legitimately could compel Americans to purchase health insurance, because the country is obligated to pay for the uninsured when they get sick. Justice Antonin Scalia responded: “Well, don’t obligate yourself to that.”

The Republicans increasingly are officially committed to the view that, if you get sick and you can’t pay for it, that’s your tough luck. They are, for the most part, decent people who don’t really mean that. They should stop saying it.


* Jonathan Adler is a regular contributor to the Volokh Conspiracy blog, a Libertarian leaning blog for legal professionals who are responsible for mainstreaming many of the anti-ObamaCare arguments pursued by these lawyers in Court.

In January 2014, after Jeff Bezos purchased the Washington Post, the Post announced a partnership with The Volokh Conspiracy, essentially replacing the several excellent Wonkblog reporters at the Post who left to join Ezra Klein at The Wonkblog is now a weak shadow of its former greatness (I relied on its excellent reporting daily).

There is a journalism ethics line crossed when the lawyers making these unethical arguments against ObamaCare that the Post’s hard news reporters cover in its pages have ready access to the Post to propagandize their unethical arguments to their heart’s content in the Volohk Conspiracy at the Post. There is no editorial “gatekeeper” check on what these lawyers are posting.

Of course, the Washington Post previously partnered with Pete Peterson and Fix the Debt to spread his propaganda about the need to reduce social security and Medicare benefits to reduce the deficit. The Washington Post Lets Pete Peterson Write The News On The Deficit. So journalistic ethics long ago departed at the Post.

As is evident from the Post’s editorial pages which are dominated by what Charles Pierce refers to as “Fred Hiatt’s Hiring Hall For Unemployables” (e.g., Michael Gerson, Marc Thiessen, etc.) and home to the Neocon architects of the Iraq war.

The Washington Post is well on its way to becoming no more credible a news source than its former competitor, the Washington Moonie Times.

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AZ BlueMeanie
The Blue Meanie is an Arizona citizen who wishes, for professional reasons, to remain anonymous when blogging about politics. Armed with a deep knowledge of the law, politics and public policy, as well as pen filled with all the colors stolen from Pepperland, the Blue Meanie’s mission is to pursue and prosecute the hypocrites, liars, and fools of politics and the media – which, in practical terms, is nearly all of them. Don’t even try to unmask him or he’ll seal you in a music-proof bubble and rendition you to Pepperland for a good face-stomping. Read blog posts by the infamous and prolific AZ Blue Meanie here.