Saturday, August 9, 2014

One Argument for Supporters of Obamacare Not to Use

This article tries to argue that case that Congress could not have mean to exclude federally created exchanges when it said "exchange established by the state" by citing various instances in which the statute uses that phrase in ways that can't possibly exclude federal exchanges:
Elsewhere in the statute, Congress referred to state-established exchanges when it clearly meant exchanges more generally. The ACA, for example, limits who can buy insurance on an exchange to those who “resid[e] in the State that established the Exchange.” Read literally, this would prohibit anyone in states with federal exchanges from buying insurance on those exchanges. Federal exchanges would be useless. That can’t be what Congress meant.
I would strongly recommend against making this argument.  Obamacare opponents are apt to seize upon it and make it seriously.  If a state declines to set up an exchange, then residents will be forbidden from buying insurance on a federal exchange.  Hurray!  That will allow states to block anyone from benefitting from Obamacare by declining to set up exchanges, and strengthen the constituency for repeal (since so many people do not benefit from the monstrosity).

Or consider this argument:
Similarly, the ACA says that states have to maintain their Medicaid eligibility standards until “an Exchange established by the State” is up and running. This provision was meant to provide stopgap protection for Medicaid beneficiaries until the exchanges went live. But, read literally, it would forbid a state that declined to establish an exchange from ever relaxing its Medicaid standards. Again, that’d be batty.
Once again, if you make this argument as an absurdity, Obamacare opponents will probably seize upon it and make it seriously.  That will allow them to reap two benefits at once:  (1) It will prevent any broadening of Medicaid eligibility and ensure that poor people cannot receive broader access to healthcare; and (2) it will allow them to blame Obamacare.  Two for one!

If you keep in mind that the two-fold goal of opponents of Obamacare is to prevent people from benefitting from it, and then to complain that no one is benefitting, these arguments play right into their hands.  So beware of making them, lest you be taken seriously.

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