Affordable Care Act
The battle over subsidies continues
By Holly L. Meade
Healthcare. It’s something that affects everyone in America. One person dies every 12 minutes in the United States each year because they lack health insurance, according to a Harvard Medical School study. Researchers also say American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.
“We’re losing more Americans every day because of inaction … than drunk driving and homicide combined,” says Dr. David Himmelstein, a co-author of the study and an associate professor of
medicine at Harvard.
As Americans remain concerned about their healthcare coverage, the fierce debate continues over Democrat’s efforts to reform the nation’s $2.5 trillion U.S. healthcare industry. It is obvious the Obama administration has made the overhaul a top priority on Capitol Hill.
The latest healthcare battle involves insurance subsidies, cost assistance that lowers the amount of monthly premiums or reduces out-of-pocket medical expenses. Recently two federal courts offered separate opinions on whether the Affordable Care Act (ACA) or “Obamacare” allows health insurance subsidies in states that did not set up their own health care exchanges.
A panel of the U.S. Court of Appeals for the District of Columbia Circuit sided with Republicans and struck down a major part of the federal healthcare law, ruling that the insurance subsidies that help millions of Americans pay for coverage are illegal in three dozen states. Less than two hours later, a panel of the U.S. Court of Appeals for the Fourth Circuit sided with Democrats and handed down a contradictory ruling on the issue in a separate case, raising the possibility of another battle over the law playing out before the Supreme Court.
The conflicting rulings give traction to the most serious current threats to the ACA, which has been battered by a series of legal challenges since it was enacted four years ago. The latest dispute centers on whether the subsidies may be awarded in states that chose not to set up their own insurance marketplaces and instead left the task to the federal government. “It’s absurd to think that Congress intended those subsidies be available only in the state exchanges,” Senate Majority Leader Harry Reid said after the court decisions.
However, new evidence suggests that is exactly what Congress intended.
Supporters of the law wanted to deny the subsidies in order to encourage states to form their own exchanges, Jonathan Gruber, an economist at the Massachusetts Institute of Technology and one of the main architects of the ACA, claimed in 2012. “What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits,” Gruber said in a 2012 presentation on the ACA for Noblis, a nonprofit research organization.
A video of Gruber’s presentation was recently made public by the Competitive Enterprise Institute, a libertarian think tank. Gruber was then interviewed about the remarks by The New Republic, a liberal news magazine. “I honestly don’t remember why I said that,” he said. “I was speaking off-the-cuff. It was just a mistake. People make mistakes. Congress made a mistake drafting the law and I made a mistake talking about it. But there was never any intention to literally withhold money, to withhold tax credits, from the states that didn’t take that step. That’s clear in the intent of the law and if you talk to anybody who worked on the law.”
Breitbart.com, a conservative news and opinion website, uploaded audio of Gruber speaking around the same time in another venue where he states even more explicitly that the ACA denied subsidies to citizens in states that did not set up their own exchanges. The law did that, Gruber clearly explained, so that voters in those states would encourage their elected representatives to set up the exchanges.
Psalm 20:7 says, “Some trust in chariots and some in horses, but we trust in the name of the Lord our God.” As long as there have been armies and weapons, nations have boasted of their power. However, King David knew that the true might of his nation was not in weaponry but in God. So whether the issue concerns firepower or healthcare policies, ultimately America’s government leaders must place their confidence in God who gives eternal victory. Each time this topic of the Affordable Care Act comes to mind, pray that they do.
Holly Meade is a communications specialist, writer, speaker and teacher with a master’s degree in mass communication. She has extensive experience in creating and producing content for radio, television and the Internet.
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