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You Can Have Their Answer Now, If You Like

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If 5 Republican judges take away health care from upwards of 10 million people, what will the federal and state Republicans who could fix the problem do about it? Why, nothing, of course.

It may be worth clarifying briefly about why my assessment is more pessimistic than Jon Chait’s (here and here.) I do agree with a couple of his points. Wrecking the exchanges probably will generate more political opposition than turning down the Medicaid expansion. I also agree that it’s not accurate to say that reversing King would destroy the ACA. The immediate result would be polarization, and if the Democrats can hang on to at least one of the federal veto points necessary to keep the ACA from being repealed, eventually many states would establish exchanges, and the next unified Democratic government would pass a federal fix immediately.

Put this way, it doesn’t sound that terrible, but:

  • Even assuming that every state outside the Deep South has an exchange with available tax credits (and the Medicaid expansion) by 2025 or so…that’s still an awful lot of completely unnecessary pain and suffering inflicted by the Supreme Court (and the decision on the Medicaid expansion was every bit as irrational and incoherent as a decision reversing King would be.)
  • If Republicans do assume full control of the government, the chaos created by wrecking the exchanges makes it more likely that they would be able to repeal or mortally wound the ACA.
  • I’m not nearly as convinced as Chait that Republicans will take the blame for the chaos.  A lot of voters are going to blame “Obama” for anything associated with “Obamacare.”   I hope Chait is right that this will play out like government shutdown scenarios, but I’m not sure it will.
  • And we should remember that after taking the political damage for a stupid shutdown, congressional Republicans…won big in 2014 anyway.  Elections aren’t referenda on single issues, and Republicans with safe seats at the federal and state level can both take the hit and have more to fear from Republican primary voters than the general electorate.   As I say in the piece, Sam Brownback should give any optimist pause — his agenda was enacted, it couldn’t possibly have worked out any worse, and he was re-elected anyway.

Exactly how bad the Court joining the Moops resistance army would be depends on various contingencies, but it would be bad.

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