<p>That’s Jonathan Gruber.</p>
<p>New Jersey does not have a state marketplace.</p>
<p>Yes, sorry, Jonathan not Mark. The mega point being the bill was intentionally obtuse and unclear. Frankly, it was not even written when passed…things were filled in later. So, now someone has to interpret and arbitrate the mess. </p>
<p>The mega point was to get insurance to as many people as possible. The idea that a time bomb to insure fewer people was intentionally written into the legislation is beyond far-fetched. </p>
<p>Jonathan Gruber also said this:
He’s billed as an architect of this mess. Add in Johnathan Cohn, who’s supposedly a smart guy who was plugged into reporting on the issue, talking about the short-sightedness of a state opting out of an exchange, and the argument this is anything like a typo sort of collapses.</p>
<p>Doesn’t seem to be any real problem here at all. If the Supreme court rules that the IRS doesn’t get to do the clarifying of after the fact intent, then we can expect Congress to step right up and fix it. </p>
<p>No?</p>
<p>If the Congress wanted to make access to subsidies universal why limit the subsidies to just exchange plans? Why not off exchange plans too? Particularly when some state exchanges were failing spectacularly like Oregon and Maryland. </p>
<p>Because the whole point of the exchanges is to coordinate the payment of the subsidies.</p>
<p>Without the subsidies, there is no need for an “exchange” – everyone could buy their policies directly from the insurance companies. </p>
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<p>NJ does not have a state marketplace. If the lawsuit succeeds, in federal-exchange states such as New Jersey, current individual insurance prices will just be a distant happy memory, both for people who bought on the exchange and people who bought off the exchange. Having guaranteed issue, but no subsidies and (effectively) no individual mandate is a good way to break a health insurance market. </p>
<p>I’m fortunate to live in California, but unlike emilybee I’m not happy at the thought of other states having broken insurance markets. Real people who either won’t be able to afford insurance, or will pay an arm and a leg for it.</p>
<p>But if we go back, some of the people we have encountered who are so opposed are not affected or were not in hardship and don’t think they’ll be hurt if ACA goes away. They don’t see this beyond “me and mine.” Oh, they purport to have some empathy, but it’s been for select examples.</p>
<p>It’s true we see some rates rise, for some income levels. But they miss the magnitude of what this tries to accomplish. And in what I see as a stretch to prove this unconstitutional, I think some miss the intricacies of what the working within the bounds of the Constitution allows. </p>
<p>This particular “issue” with the law has nothing to do with a lack of transparency–it results from some sloppy drafting and some clever lawyering to exploit it. It was clear to anybody who was paying attention that the intention was for the subsidies to be paid in states without marketplaces. If the Supreme Court overturns it, they will either have to ignore Congressional intent and focus on the drafting issue, or pretend to believe silly falsehoods about the intent. Everybody who really knows the score understands this, and the challenge is going forward in the hopes that the environment outside the courtroom will persuade Roberts to change course.</p>
<p>The NJ legislature twice created an exchange. As I posted earlier they will create an exchange for a 3rd time if the court rules the federal exchanges are not eligible for subsidies. </p>
<p><a href=“New Jersey health insurance marketplace guide 2023 | healthinsurance.org”>http://www.healthinsurance.org/new_jersey-state-health-insurance-exchange/</a></p>
<p>Slightly off topic, but not really: DH got his annual letter from Anthem about next year’s premium. You have to understand that in the past, this has been one of the most dreaded events of the year in my house. 12-15% increase was a good year, and meant he got to keep his insurance. Often the increase was in the 20s, and several times in the 30s. In those years, we had to decide if it was time to step down his coverage so that we could keep the premium affordable. He had to step down on average every 3 years.</p>
<p>This year: 6.9%. And we need not fear the Supreme Court, because California has its own exchange. :-)</p>
<p>Yay, LasMa! The Fang family is still on COBRA, but sometime next year we have to go to the individual market. I think Fang Jr will buy a policy from Kaiser this enrollment period.</p>
<p>I should add that DH doesn’t get a subsidy, so an adverse SCOTUS ruling wouldn’t affect him directly in that sense. But he is in the individual market, so his premiums would quickly skyrocket anyway, if we didn’t have our own exchange.</p>