In King v. Burwell, the Supreme Court has another, probably final, opportunity to gut the Affordable Care Act, but will it? I am not an attorney, but it seems that the legal logic is clear and the evidence is compelling that the intent of the letter and spirit of the law is that only exchanges authorized by the states can validate the health care premium subsidies. Even MIT Obamacare mastermind Jonathan Gruber openly admits this. However, and I hope I am wrong, I’m betting that the politics will win out and that the Chief Justice will once again bail out this abomination in “compassionate” deference to the resulting impact of the elimination of the subsidy for ten or so million people and the damage he thinks will be inflicted on the institution of the Court.
Even if the Court does rule for the plaintiffs, there seems to me little likelihood that President Obama will in any way work with Congress to fix the law. Rather, he would probably adopt a strategy to put enormous pressure on the states without exchanges to either establish them or partner with the federal exchange. As I have previously predicted, at the end of the day, in January 2017, no matter who is elected President, the best case is that he or she will inherit a new and untouchable entitlement program distributing premium subsidies to 15 or 20 million people, having succeeded in nothing else among its original objectives in terms of affordability, availability, or quality of delivery. Worst case: if Hillary Clinton is President, we’re a very small step to a universal single-payer system, her 20+ year dream.