Poll: 58% of Registered Voters Think Obamacare Enrollees on Federal Exchanges Should Receive Subsidies. So Halbig Rationale Was “Plausible”

August 5th, 2014

The Hill reports on a new Morning Consult poll, concerning whether people want to be able to receive subsidies on federal exchanges:

Fifty-eight percent of registered voters in a Morning Consult survey said all ObamaCare enrollees should be eligible for subsidies to reduce premium costs regardless of whether their insurance plan was bought on exchanges set up by states or the federal government. Only 15 percent thought otherwise . . . .

While 71 percent of Democrats sided with the Obama administration’s position, so did 49 percent of Republicans. Only 23 percent of Republicans said the subsidies should not be available to all.

Almost a majority of Republicans support this. Take these numbers with a grain of salt, as this poll has absolutely nothing remotely to do with the statute or Halbig, as most voters had no clue:

Most voters, though, said they knew little about the court cases at issue. Fifty-seven percent of registered voters said they had heard nothing or very little about them, and only 14 percent said they had heard a lot.

I think this proves the exact opposite of what The Hill suggests. Of course people would want to receive subsidies regardless of who establishes the exchange. People like free stuff, regardless of what the statute says. Any actions taken by state politicians that deprived their insurance-buyers of free stuff would be *extremely* unpopular. Voters have a way of pressuring elected officials to taking free federal money. If the statute was taken literally, to avoid massively unpopular costs being passed on to tax-payers, states would have played ball. To quote Jon Gruber:

If you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits. …I hope that that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges.

In other words, these numbers reaffirm that the D.C. Circuit and the 4th Circuit were correct in finding “plausible” the rational that the federal government attempted to punish uncooperative states.

Both courts acknowledged that legislative history does not say how these four words made their way into the statute. With this silence, the Fourth Circuit noted that “it is at least plausiblethat Congress would have wanted to ensure state involvement in the creation and operation of the Exchanges.” The D.C. Circuit likewise observed, “the most that can be said of [the challenger’s] theory is that it is plausible.” It’s telling that both courts independently came up with the exact same description: “plausible.”

Recall that this was the same approach taken to inducing states to “join” the Medicaid expansion–expand Medicaid or lose your entire budget.

Keeping the history of the law’s Medicaid provisions in mind, consider again whether it is indeed “plausible” that someone in the Senate—or maybe even an influential lobbyist or academic helping to draft the bill—intended with these four words to dangle similar carrots to induce unwilling states to establish health insurance exchanges. Perhaps some states would have initially declined to build exchanges, and in those cases HHS had the authority to operate a federal exchange as a backup. Could red-state governors have long handled the backlash from their citizens being punished with unaffordable insurance premiums? Maybe. Maybe not.

But such an incentive structure is at least consistent with the thinking behind other provisions of Obamacare: that states can be made to swallow bitter pills.

Very few states would have swallowed this bitter pill, which would result in insurance premiums costing the sticker price, rather than the subsidized price. Virtually all of the states would have established exchanges–as expected.