Exchange Of Fire

The Republicans are moving on to the next step in dismantling the post-SCOTUS Affordable Care Act in a presumptive President Obama second term:  wrecking the insurance exchange subsidies.

At issue is whether the subsidies will be available in exchanges set up and run by the federal government in states that fail or refuse to establish their own exchanges. 

Critics say the law allows subsidies only for people who obtain coverage through state-run exchanges. The White House says the law can be read to allow subsidies for people who get coverage in federal exchanges as well. 

The law says that “each state shall” establish an exchange. But Washington could be running the exchanges in one-third to half of states, where local officials have been moving slowly or openly resisting the idea. 

The dispute has huge practical implications. The Congressional Budget Office predicts that 23 million uninsured people will gain coverage through exchanges and that all but five million of them will qualify for subsidies, averaging more than $6,000 a year per person. Subsidies, in the form of tax credits, will be available to people with incomes from the poverty level up to four times that amount ($23,050 to $92,200 for a family of four). 

And if the states that refuse to set up exchanges have the federal government come in to do it for them, and then the GOP turns around and sends yet another case to the Supreme Court where the federal exchanges can't work because there's no subsidies, it will be a disaster.  And yes, the Republicans figure all the people screwed out of health insurance will blame Obama and the Democrats.

So yeah, they don't mind playing with people's lives.  It's politics, dammit.