PD Editorial: The healthy returns on affordable care

Deep blue California and dark red Kentucky, home of the incoming Senate majority leader, are Exhibit 1 and Exhibit 1A of the Affordable Care Act’s first-year success.

Between them, the Golden State and the Bluegrass State enrolled more than 2.5 million people, with each state cutting the number of uninsured by about half during the first 12 months of President Barack Obama’s health insurance program.

But the top story of Year 1 wasn’t expanded access to medical care. Neither was the political gymnastics of Sen. Mitch McConnell, who managed to suggest during his re-election campaign that his new Republican majority could repeal the Affordable Care Act without shutting down his state’s popular health exchange.

There’s no denying that the dominant story was the botched rollout, when swamped enrollment portals collapsed, leaving millions of people exasperated and angry. Solving the technical problems took weeks. The political wounds are still healing.

Open enrollment for Year 2 begins today, and state and federal officials desperately need to avoid a repeat of last year’s problems.

During a visit to Petaluma this week, Covered California officials said they have upgraded the web portal, more than doubled the number of customer service representatives and added 200 storefront locations with evening and weekend hours to help people purchase health insurance or renew policies.

The Washington Post reported that Obama administration officials and government contractors have been preparing contingency plans in case there are more technical problems with healthcare.gov, the website for residents of about three dozen states that didn’t create their own health care exchanges.

Lost in all the discussion of server capacity and throttling protocols is promising news on premiums.

Despite scare-mongering about skyrocketing rates from critics of what’s commonly called Obamacare, a recent study by the Kaiser Family Foundation found that, on average, individuals will pay less in 2015 than they did in 2014 for silver plans, the second-lowest cost option.

In the North Bay region, which includes Sonoma County, premiums will increase an average of 5.4 percent for 2015. However, according to Covered California, federal subsidies will more than cover the rate increase for most people.

Democrats took a pasting in last week’s election, but the Affordable Care Act wasn’t a major issue in most Republican campaigns. Some states are rethinking their refusal to open health exchanges. Yet there also are calls to repeal the law as the GOP prepares to assume control of the Senate in January.

Any such inclinations may be blunted by public satisfaction with expanded access to health care and affordable premiums.

There is, however, another threat to the Affordable Care Act.

The U.S. Supreme Court agreed to consider a challenge to the subsidies offered to help those with limited income comply with the requirement to obtain health insurance. One provision of the law says subsidies are available for insurance purchased through state health exchanges. But in 37 states, residents must use healthcare.gov, the federal exchange.

It’s clear that Congress’ intent was to include subsidies for those who use the federal exchange - Justice Anthony Kennedy said as much in his dissenting opinion when the court upheld the Affordable Care Act last year. And, as legal commentators have pointed out, justices traditionally read statutes in context and avoid invalidating legislation due to minor drafting errors.

If the court ignores its own precedents, millions of newly insured people could again find themselves without coverage. In what universe is that good judgment?