John Burris: A Sausage Biscuit With Cheese, Jelly And Obamacare

The Supreme Court issued two rulings last week. In one, they ended a multi-year lawsuit challenging the federal government’s establishment of a healthcare exchange, which provide insurance subsidies to low-income earners in dozens of states. In the other, the court invalidated all state laws prohibiting gay marriage.

The rulings are significant, but the reactions to them are too. It seemed easier for Republicans to begrudgingly accept the reality of gay marriage than it did to accept the same of insurance subsidies. On marriage, most governors, senators, and legislators said they would work to painlessly implement the new normal in their state, despite not personally supporting the change.

On insurance subsidies, the ruling might as well have never happened. Statements were outraged, indignant and harsh. There were vows to repeal and replace all of Obamacare, just like there were before. Virtually no Republican dared say the ruling offered any finality to the debate.

Sure, there were some who spoke equally harsh of both, and individual opinions do genuinely vary issue to issue. But as a general rule, politicians seemed more afraid of the appearance of weakness on anything related to Obamacare than the appearance of weakness on gay marriage.

The reality is that the acceptance and voicing of reality can present the appearance of weakness. That’s not weak of me to say. Sometimes, rage without focus is applauded. It’s been the case with healthcare for some time.

That’s what led to the King vs Burwell challenge, orchestrated by Michael Cannon of the Cato Institute, a libertarian “think tank.”

In 2013, I had breakfast with Cannon in the basement cafeteria of the State Capitol. I ate there daily because I love a sausage biscuit with cheese and grape jelly, so it was the perfect setting for a talk on healthcare.

We met in the immediate shadows of the first court challenge to Obamacare, in which Justice Roberts declared the added coverage aspect of the law to be optional, causing discussions of what would eventually become the Private Option. People that I respected asked me to meet with him, so I did.

Our personalities didn’t exactly mix, so it wasn’t a very long breakfast. His message was short and confident. He said that Obamacare wasn’t going to be the law for very long, and that he was working on a court challenge on behalf of an Oklahoma plaintiff who would challenge the federal exchanges.

I told him I doubted his plan. He told me he doubted mine. That’s the only time we ever disagreed, probably because it’s the only time we ever talked.

I don’t doubt the merits of his argument. I certainly don’t doubt the intent. He sued against a bad law that was poorly crafted, far too imposing, and much too restrictive. It focused on coverage, not reform. It punished states with federal tax increases and Medicare cuts.

I disagreed with his approach because it didn’t seem to give conservatives the greatest chance to mitigate the damages of a bad law. He worried about the subsidies. I worried about the federal tax increases and Medicare cuts imposed to pay for the subsidies. He believed in another lawsuit. I believed in leveraging federal waivers for state innovation.

We were both trying to assess reality. I may have just been further along in the grieving process than him.

Like Cannon, many conservative bloggers, radio hosts, and “think-tank” personalities have spent years coming up with the next most clever way to completely destroy all of Obamacare. They might be well intentioned, but that doesn’t make them right.

A real strategy for dealing with Obamacare was never to hope that the Supreme Court would outlaw it, or that Congress would fix it. States must lead the way on discussions of coverage and reform.

Arkansas is well-positioned now. We’ve made some progress, and the Healthcare Task Force has competent members and leadership to make even more.

I asked Rep. Charlie Collins – the co-chairman – about his thoughts on King v. Burwell. He told me that he “wishes the Supreme Court would have repealed Obamacare’s twelve new taxes and drastic Medicare reimbursement cuts. We on the task force will continue to develop market-based reforms to help create healthcare heaven in Arkansas and beyond.”

The Supreme Court has ruled. Subsidies, mandates, and federal tax increases are here to stay for now, just like gay marriage. Fortunately, there’s much more to healthcare than those things alone. Insurance subsidies aren’t the problem. Other things are.

That sounds like something worth talking about over breakfast.