Well, it seems the worm has turned in a very strange way, and I have to admit that I’m feeling a little bit smug about it all.
The Supreme Court is going to be looking at a provision in the Affordable Care Act to see if the Internal Revenue Service overstepped its authority. The provision was to give tax credits to health exchanges that provided the coverage for the now nearly 9 million people who’ve signed up for it.
The reason for the case is that Congress is usually the entity that passes tax law and determines how credits work. The question is whether passage of the ACA allowed the IRS to take on this role or not.
The reason I’m kind of smug? Because back in 2012 I stated in post titled 4 Financial Implications Of The Health Care Bill that hospitals would do well under this bill because more payments would come to them on high cost procedures and long term stays.
There were many hospital finance people who lamented that this act was going to hurt them. It turns out that, per this story from CNBC, I was right on that front. Seems many hospitals are now worried that the Supreme Court could overturn what the IRS has done, the ACA could be crippled enough to make it go away, and hospitals will be thrown back into the old system where they’ll once again be scrambling for cash. If people wanted hospitals in their communities to close or merge with other hospitals and now have to drive further for some services, you should be celebrating… maybe…
You know what else in interesting? It seems that many of the states that had Republican governors who said that they weren’t going to allow the ACA in their state, which was their right, not only ended up bringing it into their states but now are worried themselves that it could go away and cause them problems with coverage as well.
Not only the states, but Republican politicians are also worried, though more about their political future than the people themselves (my opinion). For instance, this from the LA Times:
Ultraconservative Sen. Ben Sasse (R-Neb.) laid out the consequences starkly this week in a Wall Street Journal op-ed. “Chemotherapy turned off for perhaps 12,000 people, dialysis going dark for 10,000. The horror stories will be real. What will happen next is predictable: A deluge of attacks on Republicans for supposedly having caused this.”
Wow; what a turnabout eh? So, what’s your take on this? Here’s mine.
Like almost everything else, it’s going to come down to partisan politics. I predict a 4-4 split, which once again will leave it all up to Chief Justice Roberts, who made the deciding vote that allowed the ACA to go live in the first place. Here’s the thing; the entire thing pinges on just a few words in the entire bill; does the Supreme Court throw out an entire bill that could affect so many millions of people because of a few words?
I don’t know, but since I’m on a winning streak I’ll go out on a limb and say no. It would be an amazing move, knowing how many lives it would affect. Not that the Supreme Court has always gone the route of the populace, but it’s rare that they’ve taken extraordinary steps against people (Dred Scott and Jim Crow laws notwithstanding).
So, we’ll see. I do have a personal stake in this since, because of the ACA, I now have coverage. At the very least I might not have coverage and save about $1,000 a month, which is a double edged sword because anything catastrophic that happens to me will be back on the citizens of my state. If this law is taken away… I can live with that.