In July, shortly after President Obama announced his plans to explore options to address the country’s immigration issues via executive order, House Speaker John Boehner announced that he would be suing the president. The suit, however, was not about immigration, but about the Affordable Care Act. By allowing the delay of certain provisions, Boehner felt that the president was essentially changing the law without Congress’ approval. In August, the House voted to move forward with the lawsuit.
As promised, the president announced those executive actions last week. Less than a day later, Boehner filed their lawsuit. It was somewhat surprising considering that the suit had had several delays, two law firms dropping the case, and it having absolutely no legal basis. Nevertheless, just a week after they secured the services of George Washington University legal professor Jonathan Turley, they filed their suit.
Most observers feel it has little chance of moving forward, but it’s just the latest in a long line of trying to destroy the law that has changed lives.
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Republicans have been trying to stop the ACA since it was first drafted. They have made more than 50 attempts to repeal or otherwise alter the law. Since being fully implemented this year, and in spite of a few notable hiccups, the law is working as it should. Millions more people are being insured for less and getting more coverage.
This will be a problem for Republicans.
The new Republican majority in Congress is expected to continue try to repeal, or at least weaken the law in the next session. This could be political suicide as more Americans begin to understand the benefits, which will increase its popularity. Continuing down this road could also hurt them where it matters most – in their pockets.
The health insurance industry has long been major campaign contributors for politicians. As talk about changing in the way health care is delivered in America began to get louder, the industry backed those who were most supportive of the status quo. That often meant Republican candidates would benefit from health insurers’ support.
Health insurers still want the status quo maintained, which now means keeping the ACA in place.
Besides consumers, there is little doubt that health insurance companies have gained the most from the ACA. Millions of new customers have been funneled into both their private plans and Medicaid, which private insurers often manage through state contracts. Even with the increased coverage, and the requirement that they spend 85 percent of every dollar received on medical care, insurance companies have continued to make a profit under the law.
They are also benefiting from the federal subsidies that consumers get via the health insurance exchanges.
As part of the cost-sharing reduction, the federal government pays part of the premium for those whose income is up to two and a half times the poverty threshold ($29,175 for an individual). The Congressional Budget Office estimates that these payments could equal as much as $175 billion over the next 10 years. These payments are at issue in the Boehner lawsuit, as well as a case that is currently at the Supreme Court of the United States.
Both of these cases could directly affect health insurance companies’ bottom lines.
After initial push-back when the law was being drafted, insurance companies were able to get many concessions that allowed them to support it – or at least not publicly fight against it. In the nearly five years since the law was passed, insurance companies have built their businesses around the law. An industry expert expects that the business from Medicaid, Medicare, and the individual exchanges will increase by 50 percent within 10 years.
These markets will grow faster than the employer-based insurance market, which is already declining.
As a result, the health insurance industry and the Obama Administration have created an alliance to push back against attempts to what would amount to a complete dismantling of a new system. Their motivations may be different, one fighting for profit, the other for what they feel is right for the country, but they have a common focus. It is rather ironic that the insurance companies don’t wish to go back to the decades old model that they fought to protect (along with Republicans) because the new model is even more beneficial.
It’s a rare moment where (almost) everybody wins.
While cases continue to wend their way through the courts, it is unclear if ACA opponents will have the same amount of support on their path to repeal. However, don’t be surprised if the drumbeat gets quieter as the campaign contributions begin to dwindle. Insurance companies used their power of the purse strings to get a law they wanted passed, they will fight just as hard to keep it in place.