There was a number for which I was watching even though I knew I could look it up if I had the time.
I was not using the TV out of laziness, but rather because my memoir finally published on June 18 and there are tasks associated with publication to ease the way for buyers. I have to assume somebody is going to buy it, unlikely as that is. This is why I did not look up the number but kept the TV on a news channel and glanced up at the chyron when I could. Mid-morning, the number finally moved past in a headline:
Half a Million with More to Come.
That’s how many people who had, as of last week, Obamacare to replace employer health insurance washed upon the medical services shores like surprised Robinson Crusoes. Very surprised. At least Crusoe knew he was on the ocean and so, however unlikely the misfortune might be, he could become a castaway. One of the most remarkable things about the delivery of medical services in the U.S. is the only place to hide is fantastic wealth. Anybody without that safety net is one black swan event from being left naked. In this case, the unfortunate souls were suddenly naked because of job losses driven by coronavirus.
Anyone who has been bitten by COBRA understands that obligating the insurance companies to offer persons jobless through no fault of theirs an individual policy circles back to the need for wealth. A friend of mine claimed that for a period of time his occupation was “stagecoach bandit” in the blurb he wrote for my memoir (the publisher made that disappear). When I read that claim, my mind’s eye flashed on one of our latter-day militiamen coming out of a large urban hospital with his assault rifle at the ready. He approached a bank of microphones and read his prepared statement under the protection of a dozen rifle barrels behind him and, as he finished, a reporter shouted a question:
Why hijack a hospital?
Rolling his eyes over the reporter’s failure to grok the statement just read, the gunman tried again by channeling Willie Sutton:
Because that’s where the healthcare is.
I remember the sense of desperation when I went naked, without medical insurance. I lost access to the University Student Health Center but was not making enough money in my brand new law practice to buy private health insurance. For a while, I could be carried on my wife’s insurance, but when she got admitted to law school she could not work full time — the law school advises you not to work at all but that was not an option for me or for my wife.
Working class personal privilege remark: Thus, we were placed in direct competition with the children of the swells, who did not have to work, and the first year grades determined who would get on the law review which determined who would get internships and later jobs at high dollar law firms.
It’s all about merit.
It’s scary to be without health insurance, particularly when we suddenly had a new baby. If you ever take in a baby on an emergency basis, you will understand why god(s) provided a nine-month glide path for most people.
So it was that the public policy side of me heaved a sigh of relief to know that half a million people (with more coming) pitched off employer coverage and unable to afford COBRA were caught by a safety net called Obamacare, with its subsidized premiums.
As best we can tell, the lucky majority who contract a coronavirus infection and survive it will be carrying around an array of pre-existing conditions. I am not greatly surprised at such discoveries because I “beat” cancer only to discover that cancer left nasty and permanent damage in my body that my oncologist says is not unusual. I guess we don’t hear much about that unless we get cancer, because when you are fighting the cancer and right after the “win,” it seems petty to complain about anything that will not kill you right away.
In what insurance companies call the halcyon days before Obamacare, many of them supported a whole department of employees tasked to discover pre-existing conditions whenever somebody presented with an expensive claim.
With the wave of newly unemployed still to come, Obamacare will be a money pit, a major test of our determination to face this emergency together. The healthy and employed will be taxed to provide for the coronavirus victims who don’t get their jobs back. Social Security Disability Insurance could be another money suck, depending on what kind of gifts the pandemic leaves with the survivors.
In other news, the Trump administration spurned what may have been a last chance to bail out completely or support the public interest in Texas v. United States when it filed a brief in the SCOTUS arguing that the Affordable Care Act is unconstitutional. If Mr. Trump had offered an alternative other than just cut people loose with no coverage and let people who have coverage get claims denied on pre-existing conditions, this would be a different conversation. But this difficulty dates from when the entire GOP rested all legislative campaigns on a jihad against Obamacare. The whole reason for the sobriquet for the Affordable Care Act was to wrap the new law around the neck of Obama and any Democrat.
This tactic was attempted against Democrats who opposed the Affordable Care Act or who were not in Congress at the time.
So is this lawsuit started by Texas and joined by Mr. Trump frivolous?
It’s not surrender-your-law-license frivolous. Think back to the original legal attack on the Affordable Care Act. It was centered on the most unpopular provision: the health care mandate that nobody will be allowed to go naked. No free riders, said Congress. The young and healthy subsidize the old and sick. Does the Constitution allow this communist mechanism? The SCOTUS said in so many words that the Constitution does not mandate capitalism (or any other ism) when it switched direction on New Deal legislation after the Switch in Time that Saved Nine.
The SCOTUS was split 4–4 when along came Chief Justice John Roberts and scrawled his name in arch-conservative infamy by upholding the law under the taxation power. This judge thinks the commerce clause would have worked just fine, but I guess that’s why Roberts is up there and I’m down here.
Along came Congress and set the individual mandate penalty at zero, which zeroed out the argument that the mandate is a tax .
There are many ways the SCOTUS could decide California v. Texas (as the case is now styled because Texas won in the Fifth Circuit Court of Appeals, the Department of Justice AKA The Trump Law Firm switched sides and California took up the appeal) that would not wipe out Obamacare at all. I’m fond of the standing argument. So the odds are that Obamacare will not be wiped out immediately, as in over night.
My complaint here is that Mr. Trump feels that the immediate demise of Obamacare in the middle of a pandemic would be a good result. Note that the number of Americans stripped naked before the Devil Virus would be 23 million, not the paltry half a million with more to come just added. Obamacare comes out of the decade of attempts to kill it in a weakened state. Coronavirus will be pounding on a hollow shell that has lost its primary funding mechanism with the individual mandate.
The metaphorical bleeding of the law corresponds with literal bleeding by a huge class of citizens selected at random to be permanently damaged by the pandemic. Obamacare is in dire need of repair before it is stressed in this manner. If it is not repaired, the argument will be that universal health care is possible in every industrialized nation except the United States. We tried it and went broke and the GOP told us so.
I am reminded of the hot mic moment that caught Vice President Joe Biden. President Obama was about to speak about the passage of the Affordable Care Act. Mr. Biden had just introduced Mr. Obama, and as the two men passed each other Biden whispered in Obama’s ear in a manner he thought was far enough from the mic:
This is a big fucking deal!
Elections have consequences.
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Previously Published on Medium
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