The Supreme Court will rule on King v. Burwell in the coming days and the outcome could determine whether millions of people will continue to receive subsidies to purchase health insurance. But as Ezra Klein rightly points out, a ruling against the government won’t destroy the Affordable Care Act. In blue states that have set up their own exchanges (like Minnesota), the ACA will continue to function as if nothing had happened. It’s people living in red states who will suffer the consequences of an adverse ruling. And some Republicans may rue the day that this suit was filed in the first place. They’ve had the luxury of taking potshots at the ACA without having to propose a serious alternative. If millions of their constituents suddenly learn that they are losing coverage, Republicans will be pressured to come up with some kind of solution. Whether they can pass anything is another matter entirely.
I’m still cautiously optimistic that the government will prevail, but a bad decision won’t realize conservative fantasies of a wholesale dismantling of health care reform. There will be turmoil and some people could suffer real harm if Republicans refuse to act. The law itself will remain and most states will eventually find a way to ensure their citizens enjoy its full benefits.