Audie Cornish, NPR News, Author at �鶹Ů�� Health News

What’s Next If The Supreme Court Strikes Down Obamacare Aid?

Audie Cornish, NPR News — Mon, 11 May 2015 22:32:35 +0000

Millions of Americans get subsidized health insurance under the Affordable Care Act. But those subsidies are being challenged. And in the coming weeks the Supreme Court could rule that in more than 30 states, the subsidies are illegal.

To find out what federal and state lawmakers could do if the subsidies disappear, we spoke to Linda Blumberg, a senior fellow at the Urban Institute, an economic and social policy think tank. This is a lightly edited transcript of the conversation.

AUDIE CORNISH, NPR: Tell us who would be most affected if the subsidies stopped flowing.

LINDA BLUMBERG, Urban Institute: These are not the poorest people, who were targeted to get help through the expansion of Medicaid. What we’re talking about here, people who are vulnerable to losing their assistance, are really working people, low-income and middle-income workers. The vast majority of them, over 80 percent , are the workers themselves. The rest are basically families of workers. Over 60 percent of them are white, over 60 percent of them live in the South. So we’re talking about a population that is working hard to make ends meet but can’t really do everything on their own. They’re also a voting population which I think is really important, too.

AUDIE CORNISH: So help us understand for a state leader, a governor, who is faced with a potential ruling here, what are the options? If they have a federal marketplace, can they switch to a state-based one?

LINDA BLUMBERG: There should be some opportunity to switch to a state-based one. The concern is we don’t know what’s going to be required in order to make that change. One of the big challenges, though, is if states have to take on a lot of new responsibilities then there may be a lot of costs for them to do that. The states that made the decision to do state-based exchanges early on had a lot of federal grants to set them up. Those grants don’t exist anymore. It’s also very time consuming. It took years for states to get these up and running. So, if a lot is required of these states to switch over, then there’s a lot of logistical and financial challenges.

AUDIE CORNISH: What about Congress? What options do they have to try and avoid potential chaos for some of these states?

LINDA BLUMBERG: Well, the most straightforward way to both avoid chaos and eliminate the problems of people losing their health insurance and premiums going up for everyone else is that they can extend the eligibility for the financial assistance to residents of all states, regardless of who’s administering their health insurance exchanges. That’s really the best way to address this.

AUDIE CORNISH: So they would just have to change the law, basically?

LINDA BLUMBERG: Right. Really, we’re talking about a couple of words in one sentence in the law that are in dispute here. So all they would have to do is take out a couple of words in one sentence in a thousand-page-plus law.

AUDIE CORNISH: Easy for you to say; what about the political will? Lawmakers have been fighting about this law for years.

LINDA BLUMBERG: I think the political will is the enormous challenge here. There’s going to be a real tension because there’s the side that says, “Listen, we don’t want to do anything to support the Affordable Care Act.” But the reality is that the folks in states that are likely to be affected are the ones that needed the most assistance. These are the states that are most likely to have high rates of uninsurance. We’re talking about a very low income population in many of these states and a highly vulnerable population that’s going to be affected.

This story is part of a reporting partnership that includes NPR and Kaiser Health News.

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Sen. Enzi Plays Crucial Role Negotiating Health Care

Audie Cornish, NPR News — Wed, 26 Aug 2009 00:00:00 +0000

This story comes from our partner

Transcript of story:

RENEE MONTAGNE, host: Even as the health care debate grows louder and more partisan, one Senate group of three Democrats and three Republicans has continued to meet, searching for a compromise. Perhaps the most surprising member of this group, known as the Gang of Six, is a conservative Republican from Wyoming. He may represent the nation’s least populous state, but this is one senator who’s enjoying outsized influence on health care negotiations. NPR’s Audie Cornish has this profile.

AUDIE CORNISH: When the Gang of Six announced its existence earlier this year, one gang member’s name raised eyebrows: Mike Enzi. Unlike the moderates and the mavericks in the group, Enzi’s a free market conservative who represents one of the most reliably Republican states in the union, so even having him at the table with Democrats raised questions in some quarters. The conservative-minded Club for Growth even put out a TV ad attacking the health care changes in general and calling out Enzi by name.

(Soundbite of political advertisement)

Unidentified Man: Politicians and bureaucrats making health care decisions. Job-killing new regulations on small business and massive tax hikes to pay for it all. Tell Senator Enzi not to cave into the liberals on health care.

CORNISH: Earlier this summer, Enzi did stand his ground when he voted against the Senate Health Committee Bill. But the Wyoming Republican is also a member of the Senate Finance Committee, where he was tapped to be part of the so-called Gang of Six. Enzi, the Senate’s only certified accountant, has been willing to work on bipartisan deals in the past and takes this approach.

Senator MIKE ENZI (Republican, Wyoming): I work on an 80 percent rule. I anticipate and from experience have found that usually everybody can agree on 80 percent of the issues. And among the 80 of the issues they agree on, they can agree on 80 percent of anyone of those issues. And you never get a perfect bill around here. If you can get 80 percent, you can get a lot done.

CORNISH: Perhaps. But it’s not clear that approach is working on health care. So far, Enzi has only hardened his stance on issues, like fighting Medicare savings to pay for universal coverage, even though every proposal put forward so far relies on that funding mechanism.

Jack Pitney, a political science professor at Claremont McKenna College, says Enzi is important as a counterweight to the other Republicans on the negotiating team: Maine’s Olympia Snowe and Iowa’s Chuck Grassley.

Professor JACK PITNEY (Political Science, Claremont McKenna College): Some conservative Republicans might look at Olympia Snowe and say, well, she’s a moderate-to-liberal Republican. Always has been. Chuck Grassley is a bit more conservative, but has a reputation for being quirky and being a maverick. Enzi is more of a mainstream Republican. So if he comes along on something like this, there is a much stronger chance that this is going to attract some Republican support.

CORNISH: But that’s a big if. Lately, Enzi has cast doubt on whether he or any Republican will vote for any health care bill if it contains elements such as a government-run health care insurance option. That has some in the White House and Congress considering splitting the health care overhaul into two bills. One would include bipartisan changes even Enzi could support.

The other would include contentious items, like the public insurance option. And it would be pushed through using a parliamentary procedure that would allow Democrats to pass a bill with a simple majority. That’s a tactic Enzi has warned against for months.

Sen. ENZI: It’s a declaration that Republican ideas and centrists Democrat ideas are going to be left out of the mix. If we can’t come up with a plan that will garner the support of at least 75 or 80 senators, this institution will not gain the confidence of the American people.

CORNISH: Needless to say, the gap between a bill requiring 75 or 80 senators and one requiring just 50 is vast, indeed. Nonetheless, Senator Enzi says he’ll still dial in for the next Gang of Six session – a teleconference set for September 4th.

Audie Cornish, NPR News.

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