There is a 1950’s Broadway musical called Damn Yankees. It is based on a book by Douglass Wallop titled The Year The Yankees Lost The Pennant.  The premise of that novel is that the perennially hapless Washington Senators (the baseball team not the upper chamber of Congress) are given a new jolt of life when a young player from out of nowhere, Joe Hardy, gives the team a lift as he helps slug them into first place.

Ah, but Joe is really Joe Boyd, a middle-aged fan who once dreamt of starring for his home town team. But the nefarious Mr. Applegate transforms him to Hardy, expecting to collect his soul in the bargain. In the musical the song You Gotta Have Heart is sung by some of the ballplayers in an optimistic paean to the sport that soon becomes reality when Hardy hits his way into their and their fans’ hearts.

Alas Applegate threatens to pull the plug on Hardy and retransform him to ordinary Joe Boyd, depriving the people of their sports salvation.

This musical is, in a sense, being reprised now in Washington, D.C. with a new cast and no musical renditions praising heart and planned legislative action absent any heart at all. The part of Applegate is shared by Charles and David Koch.

You see with the new Republican majority in both Houses,  Congress is certain to renew efforts to repeal the Affordable Care Act. (ACA)(I refuse to use the common name for the law, deeming it derogatory). Absent outright repeal other measures may be utilized to thwart full implementation of the employer mandate or to end or severely limit the funding aspects of the law, effectively emasculating it.

To boot, the non-musical version of The Supremes is contemplating a move that will intervene to remove the repeal stigma from Congress. It has accepted the case of King v Burwell. That litigation is a challenge to the provisions of the law providing federal premium subsidies to some health policy holders based on their income.

Recall that the law established a marketplace for the new plans through exchanges, intended to be operated by the states, but with a federal exchange available should a state not act to set up its own. 36 states chose not to operate their own. Several million Americans therefore purchased policies on the federal exchange with most of them eligible for the premium subsidies.

Some unfortunate language in the law stated, in effect, that the subsidies were available only for policies purchased on state exchanges. Other language clearly demonstrates the intent of Congress to make the subsidies effective regardless of where the coverage purchased.

The Supreme Court will decide whether the narrow language of the law controls, strictly interpreted, or whether the law, and thus the subsidies, will remain as before the challenge. If the former, millions now covered may not be able to afford their insurance without the subsidies.

Now that would not be the total repeal the Republicans in Congress seek, yet it would so undermine the ACA that the delight of GOPers would be palpable.

Obviously full repeal would bring dancing in the streets…no doubt to the strains of You Gotta Have (No)Heart.

But think about it. If millions are left with policies intact but no way to afford them, or the law is repealed in toto, that means millions of people will now be up the creek with health care coverage. A SCOTUS decision against subsidies would mean the paddles would be too expensive and repeal would mean no paddles can be bought at all.

How in the world can either result be good for the United States of America? The Affordable Care Act, despite any imperfections or weaknesses, has enabled approximately ten million citizens to be covered under some health insurance plan that did not previously have that privilege. And having insurance saves lives. That is a concrete positive of the law.

Most importantly ending or severely altering the law will have devastating financial and health consequences for real people, not abstract and wrong headed political philosophies.

I don’t know that statistics have been compiled demonstrating how many lives have been saved due to the ACA, but I do know that there is ample anecdotal evidence of many cases. One is presented here. David Tedrow of Raleigh, N.C. received a life saving liver transplant earlier this year. he had fallen ill in 2010 and, as the disease progressed, finally was unable to work.

With lower income he could no longer afford the health coverage he’d had and became uninsured. Then the ACA marketplace opened last year and he signed up. With his subsidy he could afford it. But he is in one of the states without its own exchange and will lose his subsidy if SCOTUS rules wrongly. Of course under repeal he’d have no coverage at all. Remember, one portion of the law requires insurers to cover regardless of pre-existing conditions. If Tedrow losses this policy he will be unlikely to procure another at all, affordable or not.

Simon Maloy of Salon looks at the upcoming Supreme Court decision and expounds on the potential ramifications.

Maloy takes another whack at the topic in another piece. In that one he looks at the possible SCOTUS gutting of the ACA as maybe even a negative to the GOP due to the public outcry that may erupt when millions lose insurance.

The Republicans and conservatives who clamor for the elimination of the Affordable Care Act tend to carefully avoid discussing the inevitable results of the law’s demise: exploding health insurance costs, spikes in uninsurance, general chaos in the health insurance market, and the very real chance that people will die. The GOP doesn’t have a plan for what comes after the ACA, they just want it gone, no matter the consequences. If the Supreme Court rules against the government in King v. Burwell, they’d be forced to face down those consequences, and there’s a good chance they won’t like what they see.

As he notes the fix for the subsidies is simple enough…a minor amendment with corrective language clarifying that the subsidies were to apply no matter which exchange the policy was purchased on.

That will be a cold day in hell to see the GOP surrender on this issue.

So from this angle it appears that there is an enormous chance that the Republican chest will be ripped wide open an the vacant cavity where the heart normally is will be exposed for all to see. That is so whether the ACA is repealed or the Supreme Court rules negatively and Congress fails to pass the easy fix.

The only questions is whether the besotted public will finally have enough of their heartlessness.

One can only hope this musical closes in New Haven.




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  • George Wood  On November 11, 2014 at 4:23 PM

    The play / movie was much better than today’s comparison!

    Umoc193’s Blog wrote: > a:hover { color: red; } a { text-decoration: none; color: #0088cc; } a.primaryactionlink:link, a.primaryactionlink:visited { background-color: #2585B2; color: #fff; } a.primaryactionlink:hover, a.primaryactionlink:active { background-color: #11729E !important; color: #fff !important; } /* @media only screen and (max-device-width: 480px) { .post { min-width: 700px !important; } } */ umoc193 posted: ” There is a 1950’s Broadway musical called Damn Yankees. It is based on a book by Douglass Wallop titled The Year The Yankees Lost The Pennant.  The premise of that novel is that the perennially hapless Washington Senators (the baseball team not the up”

  • Devildog  On November 11, 2014 at 5:06 PM

    it shouldn’t require a law degree to understand what the ruling in this case should be (though it probably will be 5-4 against the government (though Breyer, who has a little integrity, may make it 6-3). To paraphrase Tina Turner, “what does heart (love) have to do with it”.

    What else will make it go down besides explicit language is the argument that the language was intended by the Dems to get the states to set up their own exchanges. Hoist on their own petard!

    Conservatives under 30- no heart
    Liberals over 40- no brains

    • umoc193  On November 13, 2014 at 9:31 PM

      What the Supreme Court rules and what they should rule based on the language of the law and precedent may be completely different. If they rule as you hope, they will be dead wrong, legally, morally, and for the best interests of the nation.

      • Devildog  On November 13, 2014 at 10:57 PM

        Why do you assume what I hope for- I gave my legal analysis (your assumption may, though, be correct-or it may not be).

        How can the Supreme Court be wrong legally? Its decision, by definition, is legally correct and, if overruled later, that latter decision is also legally correct.

        Take your morality and best for the nation arguments and shove it where the sun doesn’t shine. That’s for the Congress to determine not the Court!

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