Ironically, this is the argument corporate supporters of the law make.
The U.S. Chamber of Commerce, arguably the most conservative legacy institution in the U.S., was a committed foe of Obamacare throughout the legislative process and after it was passed, providing backing for Republicans running against it in 2010 and
calling for its repeal in January, 2011. So where is the Chamber now on the
King v. Burwell case that could bring the law down? Nowhere to be seen. As
Mother Jones points out, it's not just the Chamber that's missing. No major business organization filed a brief in support of the challenge. They are either sitting this one out, or filing in support of the government's case.
That's because the law is working for them, as the largest healthcare provider in the country, the Hospital Corporation of America (HCA) argues. It also argues that the challenge is "absurd."
One of Congress' goals in passing the Affordable Care Act (ACA) was to cut down on the number of uninsured people using expensive emergency rooms for medical care that would be better delivered in an ordinary doctor's office. HCA notes in its brief that its data from 15 states that use the federal Obamacare exchange show this is exactly what's happening. The company says that in 2014, uninsured patients visited the ER in its facilities 10 times for every one admission to the hospital—a sign that most of those ER visits weren't emergencies. People insured through the exchange are visiting the ER three times for every one admission. HCA estimates that "uninsured patients are 300% more likely than Exchange patients to rely on ER care."
Moreover, the data shows that a person who has obtained insurance through the federal Obamacare exchange is nearly twice as likely to use outpatient care—an indication that they are taking better care of themselves and obtaining care in a much less expensive fashion than those without insurance. "Thus, at the same time that Exchange patients are relying less on the ER, they are receiving more outpatient care than the uninsured, including care (such as chemotherapy) that is typically unavailable in the ER," HCA says in its brief. "That care is being provided in more appropriate and cost-effective settings."
HCA is beginning to see revenue stemming from the law. They actually lost money in the first few years because of the deal they struck in negotiations—they would agree to cuts in federal reimbursements for caring for the uninsured in return for the influx of new insured patients they would get once policies became available in 2014. They didn't calculate whether they'd have lost money still if the states they examined in their brief had all accepted the Medicaid expansion, which was supposed to have covered the loss in federal reimbursements. But even without Medicaid expansion, the HCA said in the brief that it is seeing new revenue come in. They write that 62 percent of their patients who have insurance from the federal exchange had never visited their facilities before, and that they would expect to lose about $350 million initially if the court overturns subsidies and far more in the future.
HCA also notes in its brief that there isn't support from the larger business community for this challenge, because the law is working out well for corporate America as well as, you know, people who need health insurance. It's a smart argument, particularly for Chief Justice John Roberts, a former corporate lawyer who has led this court giving the U.S. Chamber a winning record year after year.