King v. Burwell : Is the Pen Mightier Than Common Sense?

Almost five years ago President Obama signed the Affordable Care Act (ACA) into law. However flawed this reform was -- oh, and it was -- the fact remains that millions more Americans have insurance today. That's a big deal. But why celebrate this achievement when you can mess with it instead?

Right now, the United States Supreme Court, rather than debate some arcane point of law, is instead engaged in the semantic examination of four words: "established by the state." The outcome of what might normally be considered a high school exercise has real potential to leave millions of Americans suddenly uninsured.

Opponents of the law interpret these four words to mean that no one outside the 16 states that chose to create their own insurance exchanges may receive subsidies. Supporters believe we must not take these four words out of context; the primary goal is to continue to provide affordable health care for all Americans.

If the ACA gets overturned, the impact will be immediate. Loss of the federal subsidy would put up to 9.6 million people at risk of losing their health insurance; it would also trigger up to 35-percent increases in premiums for participants in the non-group market. But as bad as that is, the long-term implications are worse. Prevention will become an unobtainable luxury for many, leaving serious health conditions undiagnosed, untreated and able to bloom into more severe conditions. Think about what that means in a year -- and in 10 years. Now multiply that by 9.6 million, and you get an idea for just how crowded the emergency room is going to be in the future.

As you may know, I lead a company called AbilTo that helps people through difficult medical and life transitions by empowering them with behavioral health tools. It's an integral part of the continuity-of-care equation. And while we serve only a sliver of the market, we're part of a much larger community of disease prevention and healthcare transition organizations that help individuals stay out of the hospital. When companies like AbilTo are unable to provide appropriate and timely care, the result is more hospitalizations, extra trips to the emergency room and higher costs for patients, states and the federal government. In effect, everyone loses.

So, really and truly, who cares whether or not the word "state" in "established by the state" has federal or more microcosmic meaning? Let's focus on continuing to help 9.6 million people to be happy, healthy and productive. Enough said.