Lose your job, lose your health insurance. That has long been the American way. If it has happened to you, perhaps you joined the ranks of the uninsured. Or paid 102 percent of the cost to continue the plan your employer offered. Or tried to buy coverage on your own and realized the country’s health insurance system really was a mess.
Without protection from an employer, pre-existing health conditions were held against you when buying insurance. If you broke an arm a decade earlier, an insurance company could exclude the arm from coverage. It could choose to not sell you a policy or cancel it after a cancer diagnosis.
Then along came the Affordable Care Act.
Now when you lose a job you can buy a comprehensive private health plan through an insurance exchange. You can’t be charged more if you have a health problem, and you may be eligible for a federal subsidy.
Though the law is certainly not perfect, Americans have more options and protections than they had before the law.
But opponents of Obamacare are relentless. For the third time, they’ve made it to the U.S. Supreme Court with a challenge to the law. The court agreed to hear a case about the legality of the federal subsidies.
Plaintiffs say this financial help can only be used for plans offered by state-run exchanges, even though two-thirds of states, including Michigan, rely on the federal government to operate or help operate their exchanges. The only significant difference between a state-run and federally run exchange is who performs technological and administrative functions.
People have long understood how the law would work: Americans would buy coverage in exchanges and many would receive federal help paying for it, based on their income, regardless of who operated the website where they were shopping.
Congress clearly intended this. Federal rules clarified it. Even Republican governors who opposed the law understood it.
Meanwhile, opponents scoured thousands of pages of law, searching for the tiniest inconsistency or typo. They found one. The Affordable Care Act’s tax credit provision says subsidies will be available to those who buy insurance on an exchange “established by the state.” Those four words became the basis for another legal challenge.
The irony of this challenge is difficult to overlook. That’s because it seeks to abolish a practice conservatives have long embraced: Funneling public money to private insurers to cover Americans.
Known for opposing any kind of government insurance, Republicans have repeatedly said the private sector is best suited to provide insurance. They like the idea so much they encourage seniors to leave government-run Medicare and sign up for private Medicare Advantage plans, which are paid for with tax money and cost the federal government more than traditional Medicare costs.
Yet this is apparently a bad idea when part of a law signed by a Democrat president.
Opponents of Obamacare are hoping the Supreme Court has an activist majority ready to strike down the subsidies. If the court does that, millions of Americans could lose the private insurance that conservatives are so fond of.
And everyone is still waiting to hear their alternative for helping these people find and acquire health coverage.
— LIVINGSTON DAILY PRESS & ARGUS