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King v. Burwell: DeMint tells legislators, “Let the subsidies die”

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The Supreme Court will rule this month on King v. Burwell, a case arguing that Obamacare's insurance subsidies are illegal. A decision in favor of President Obama's health-care law could solidify its place in history — but one against would throw the insurance expansion into chaos.

Up until the ruling, Vox will collect the most important news, commentary, and thoughts on what could happen — and what it means for the Affordable Care Act.

"Let the subsidies die" — Former South Carolina Senator and current Heritage Foundation president Jim DeMint has some words for Republican legislators:

It would be uncaring and unfair for Congress to force taxpayers to continue funding Obamacare's subsidies that do nothing to lower the real cost of coverage nor increase healthcare choices for most Americans. Extending the subsidies would be political malpractice, not just a mere Band-Aid upon an infected wound. Rather than diagnosing the underlying disease — a broken, unsustainable system — such a patch would allow Congress and the president to avoid making the tough decisions about cost and quality of care.

This is the new Republican divide — The Wall Street Journal's Kristina Peterson and Louise Radnofsky report on the "tug-of-war" happening on Capitol Hill over whether to follow DeMint's orders:

Republican congressional leaders have coalesced around a plan to extend the tax credits potentially for as long as two years, while striking down other parts of the law. But President Barack Obama has indicated he would veto any plan that attempted to take away more parts of the law—and at the same time, the idea of extending tax credits has hit resistance among some conservatives.

So far, Mr. [Bradley] Byrne, who has voted for repealing the health law, is trying to balance what he hears from each side. Simply tweaking the law to permanently preserve the tax credits is out of the question, he said: "That’s like saying we’re going to put another set of stitches on Frankenstein and say he looks better."

Over the past week, pressure has really ratcheted up from conservatives not to extend subsidies. There's the DeMint op-ed, and also what Virginia Attorney General and current Senate Conservative Fund president Ken Cuccinelli told Bloomberg's Sahil Kapur:

If the Supreme Court strikes down the Obamacare subsidies and mandates, Republicans in Congress should not extend them. Republicans should fight for full repeal, as they promised time and time again. SCF supports conservative candidates and a lawmaker's position on Obamacare is one of the most important issues we will examine when deciding whether to support a primary challenger

As Kapur points out, "The potential political consequences of not backing subsidies also are worrying to Republicans." They'll have to deal with horror stories of Obamacare enrollees losing access to important medical treatments. But now there's a rising counter-pressure, from Republicans' conservative wing, not to extend subsidies — setting up possible conflict in the case of a King win.

Why Florida is ground zero for the King decision 7 percent of the state's population currently gets Obamacare tax credits, Lisa Hagen and Zach C. Cohen report for National Journal.

King isn't Obamacare's last legal challenge — Tim Jost runs down all the other pending lawsuits against the health overhaul.

Map of the day


Bloomberg News uses Health and Human Services data to draw up this excellent map of which American zip codes rely most heavily on the Affordable Care Act. You see that particularly in Southern states like Florida, and North Carolina, a relatively high percentage of residents buy their coverage through Read more from Bloomberg's Zach Tracer here (and while you're at it, follow him on Twitter!).

The most thorough answer to a question I get all the time: When would a King ruling take effect? When, exactly, subsidies would disappear in the case of a pro-King ruling is a question that shows up in my inbox pretty much every day now. Jeremy Earl and Ankur Goel at law firm McDermott Will & Emery have written what seems to be the most thorough answer to this question.

The tl;dr: The Supreme Court has authority to stay its ruling for a number of months, and even if it doesn't, the White House has some administrative wiggle room to keep subsidies flowing this year. Definitely do read more here.

That's all until next time. Well, except for this (hat tip to Harvard's Emma Sandoe for the delightful pun below).


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