The One Number That Explains Why Democrats Might One Day Appreciate the ACA Lawsuits
Ninety-three percent. In a YouGov/Economist poll released last month–flagged at the time by Catherine Rampell–that was the percentage of Americans over 40 who said that they received no "government subsidy to help ... pay for health insurance." It was simply wrong. People on Medicare was likely to be receiving more than they had paid into the system. (Per Rampell, a retiree who paid an inflation-adjusted $70,000 into Medicare was going to get $197,000 in benefits.) Anyone on Medicaid–that's one in five Americans*–was receiving a subsidy. Nine million people were receiving subsidies for the health insurance they bought in the federal ACA exchanges. To be fair, many of these people were under 40.
According to YouGov, 74 percent of people under 40 said they were receiving no government subsidy.
The confusing nature of the subsidies issue was at the heart of King v. Burwell, and with a few days to digest the arguments in that case, supporters of the ACA are more optimistic that the law will survive. Meanwhile, as they did in the run-up to arguments, the law's opponents are offering "off-ramps" for people caught holding unaffordable plans if subsidies are knocked out. The latest is Nebraska Senator Ben Sasse, a wonk-phenom freshman who worked in George W. Bush's HHS. He's introduced the Winding Down Obamacare Act, or WDOA (no cute acronyms here), which would treat the people whose plans were nixed to a COBRA-esque stopgap plan. Under Sasse's bill, for the first six months after a King victory, 65 percent of the affected Americans' premiums would be pay for. After that, month by month, the subsidies would drop by 5 percent. After a year and a half–right at the start of a hypothetical Scott Walker/Hillary Clinton/George Pataki presidency–they'd be spent.
Republican replacement plans, written while anticipating/rooting for an ACA collapse, are largely intended to reassure judges and voters that they'll survive the wreckage. An unexpected byproduct of the King suit is that people are hearing about subsidies, and how they fit into the Rube Goldberg design of American's insurance system. That, ironically, combats one of the problems Democrats have always had in selling the law. Voters react viciously to the idea of "Obamacare." In Tennessee, in Kentucky, and other hostile states, they are otherwise fine with the benefits of the ACA.
Conservatives like Grover Norquist have argued, for years, that the invisibility of petty taxes hurts the cause of small government. If taxpayers/voters don't see a tax, they forget that it's there and ignore chances to abolish it. If the ACA's defenders triumph in King, they may look back on the brief national discussion of subsidies as a time when more voters realized how much they depended on the kindness of redistributors.
*That's up by 6 million people from the introduction of "Obamacare."