The Last Word: Affordable Care Fact: No Plan B

By Rick Bell

Apr. 17, 2015

As much as HR is about rules and regulations managed via dashboards, spreadsheets and Google Docs, no amount of analytics on God’s green earth can forecast what’s in store when forces beyond your control wreak holy havoc on your snug little daily routine as a manager. 

Such situations seem to occur with annoying regularity, which is why most managers have developed a plan B-maker as if it’s second nature. Flipping that switch is a lifesaver for maintaining a certain level of personal sanity, not to mention workplace continuity. And, in my experience, it doesn’t hurt to build out a plan C and plan D, too.

So imagine my shock when I heard that President Barack Obama has rejected prepping a plan B should the Supreme Court rule against the Affordable Care Act in the King v. Burwell case, which challenges the legality of tax credits made available in the 2010 Affordable Care Act.

The ruling, which will come before the court’s session concludes at the end of June, is by no means a slam dunk in favor of the Obama administration. Justices could rule in favor of the plaintiffs, which could completely gut Obamacare.

Despite the president’s supreme confidence in the Supreme Court, he’s waving off an anti-administration ruling as if it were a greeting card from Benjamin Netanyahu. Coming from someone who’s obsessive about covering all the bases, this is a risky presidential precedent.

“This should be a pretty straightforward case of statutory interpretation,” Obama told Reuters, adding later: “If they rule against us, we’ll have to take a look at what our options are. But I’m not going to anticipate that. I’m not going to anticipate bad law.”

Health and Human Services Secretary Sylvia Burwell isn’t big on contingency plans, either. She told lawmakers that they have no backup plan to deal with a potential ACA strikedown by the Supreme Court.

“[We] know of no administrative actions that could, and therefore we have no plans that would, undo the massive damage to our health care system that would be caused by an adverse decision,” Burwell wrote.

No contingency plan; going it sans Plan B. If they rule against us, we’ll take a look at our options. Hoo boy. Pass the respirator; I am gasping for air, my shoulders are in knots and beads of sweat are pooling on my forehead as I write this.

Now I realize that this is politicking of the highest order. If this were an earthquake, it would register an 8.5 on the political posturing scale.

And I’m all for confident leadership. Sometimes you have to wing it. You have to take that leap, put all your eggs in one basket and go for two in the bush vs. the bird in the hand.

But this is different. The Affordable Care Act provides health and well-being to millions of people. Some 13 million Americans face losing their subsidies on the health care exchange, according to the Kaiser Family Foundation, should the justices rule against Obamacare. These are people who put their faith in the president’s plan, waded through the bureaucracy, fumbled across healthcare.govand took the time to understand what they were signing up for.

Now they’re told there is no backup plan if justices side with the plaintiffs. If I was among those 13 million, I’d be angry — angry and scared of a future with no immediate alternative for my health care.

I know, developing a formal backup plan can be time-consuming and a lot of extra work for no apparent reason. In this do-more-with-less era, resources are particularly hard to muster on a moment’s notice. And a contingency plan is only as good as the people who put it into action.

That’s not the case here. Good people in the federal government have no plan B in case the most sweeping piece of social legislation since the Great Depression is shot down.

Republican legislators do. There may not be GOP unanimity behind the so-called CARE Act — Patient Choice, Affordability, Responsibility and Empowerment — but it’s an idea put forth by Republican Sens. Richard Burr, Tom Coburn and Orrin Hatch that could become plan A should justices rule against the Obama administration. Which is more than can be said for the president’s contingency plans.

Just like employees look to their leadership for a plan to move ahead in times of crisis, millions of people now depend on the federal government for access to health care. Not developing a backup plan for the possible rebuke of health care reform may be supreme confidence in some people’s eyes. But as someone who makes backup plans for backup plans, I look at it as supreme arrogance.

Rick Bellis Workforce’s managing editor. To comment, email

Rick Bell is Workforce’s editorial director. For comments or questions email


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