Did Obama's lawyers mess up the Affordable Care Act?

A new paper from Health Matrix: Journal of Law-Medicine suggests that a missing word in the Affordable Care Act, the 2000-page law which created Obamacare, may scupper a key provision of the plan.

The Act brings into existence health insurance exchanges, federally- and state-run institutions which centralise and regulate the process of buying health insurance for people with enough income to not be eligible for Medicare. It also lays out who can get federal subsidies to buy insurance from those exchanges, the idea being that those subsidies will gradually encourage people to migrate from America's current system of employer-provided insurance to a saner system of individuals buying their own healthcare, which will hopefully lead to, among other things, fewer people dying as a direct result of losing their job.

Unfortunately, the authors of the article alledge that a drafting error by the administration's lawyers has rendered that aim unachievable. In the passage laying out who can get that crucial federal subsidy, Article 1401 the law restricts eligibility to those who "enrolled … through an Exchange established by the State under 1311." And Article 1311 defines an exchange as a "governmental agency or nonprofit entity that is established by a state."

Crucially, the definition of an exchange, for the purposes of the federal subsidy, seems to exclude federal exchanges.

The authors argue that this is on purpose, citing the words of the head of the Senate finance committee that "the bill conditions the availability of tax credits on each state creating its own Exchange". The Obama administration obviously believes the latter, with the Washington Post's Sarah Kliff arguing that:

There’s another part of Section 1401 — Section 1401(f)(3), to be exact — that requires both federal and state exchanges to report information about any credits being administered. Why would federal exchanges need to report that information, the thinking goes, if they were not administering credits?

If the difference in phrasing is a genuine mistake - a so-called "Scrivener's error" - then it will lead to a mildly embarrassing court case where that point is clarified, and that's that. But if the administrations lawyers actually did miss a clause inserted by one of the co-authors which fundamentally changes the meaning of the law, this one could run and run.

*Obama facepalm*. Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

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“Journalists are too scared to come”: Refugees on the forgotten war in Yemen

Only the few who have managed to flee the war-torn country can reveal the suffering of those left behind.

Last weekend’s BBC Our World report on the humanitarian crisis caused by the Yemen civil war highlighted that not only is the conflict a forgotten war, it is also an unknown war. Since war broke out 18 months ago in March 2015, surprisingly little has been written about the conflict, despite its similarity to ongoing and widely-reported other conflicts in the region, such as the Syrian crisis.

The main conflict in Yemen is taking place between forces allied to the President, Abdrabbuh Mansour Hadi, and those loyal to Zaidi Shia rebels known as Houthis, who forced Hadi to flee the capital city Sana’a in February. The loyalties of Yemen’s security forces are split, with some units backing President Hadi and others his predecessor Ali Abdullah Saleh, who is seen as the leader of the Houthi forces.

While these two forces have been at war, separate terrorist groups have been gaining more and more influence on the ground. Opposed by both the Houthis and Hadi’s forces, al-Qaeda in the Arabian Peninsula (AQAP) have staged deadly attacks from strongholds in the south and south-east. They are also opposed by Islamic State, which has claimed responsibility for a number of suicide bombings in Sana’a.

After rebel forces closed in on the president's southern stronghold of Aden in late March, a coalition led by Saudi Arabia responded to a request by Hadi to intervene and launched air strikes on Houthi targets.

I have spent the last couple of months working in the “Jungle” refugee camp in Calais, home to refugees from Sudan, Afghanistan, Syria, Iraq, Eritrea, Somalia – to name just a few. Having heard very little about the civil war, I was surprised to meet a handful of Yemeni men living inside the camp.

Hussein*, 28, is a film producer and dancer from Yemen who fled the country two years ago and has travelled through 11 countries to reach the Calais camp, where he has been living for just over a month. In a mixture of English and French, he tells me how groups of Houthi militia forcibly try to confiscate cameras and notebooks from both local and international journalists. He knows local journalists, friends of his, who have been threatened, tortured and even killed by Houthi forces.

He pulls out his phone and shows me a picture of his friend, Mohammed, who worked as a photojournalist, documenting brutality as a result of the war. Mohammed’s friends and family have not heard from him since April; the best-case scenario is that he is being detained, but Hussein seems pretty certain that he is dead. As a result, many who otherwise would have reported on the conflict have fled from besieged cities such as Sana’a, Aden and Taiz to the relative safety of the countryside in the north of the country, or have left Yemen altogether.

His friend Jamil, with whom he shares a tent, adds: “from other countries journalists [they are] too scared to come”. He claims that there are only “five or seven” foreign journalists in the capital city, Sana’a and tells me about journalists from the UK, France and the US who, after spending days being held up by countless militarised checkpoints while trying to reach the main cities, are then interrogated and detained by Houthi forces. If they are let go, they are harassed throughout their visit by National Security officers.

After watching his mother die during an airstrike in the city of Hodaida in January, Jamil took the decision to flee Yemen and claim asylum in Europe. He is worried about his father and his friends who are still in Yemen, especially after hearing reports that random border closures and cancelled domestic flights have been preventing crucial aid convoys of food, medical supplies and trained aid workers from accessing the citizens who are desperately in need of humanitarian assistance. Jamil reminds me that Yemen was in economic crisis even before war broke out, with widespread famine and limited access to healthcare or clean water.

Movement within the country is restricted and dangerous, and in the last twelve months alone, four Médecins Sans Frontières (MSF) facilities have been attacked and destroyed by airstrikes. Writing on 15 September 15, MSF head of mission in Yemen, Hassan Bouceninem spoke of:

“Other health centers, schools, markets, bridges . . . [that] have been attacked and destroyed by airstrikes, shelling, or bombs. Such attacks create direct victims but the war (economic failure, access problems, closing of hospitals, no health staff etc.) also causes a lot of indirect victims within the population.”

Such widespread instability and the resultant lack of access for journalists and aid workers means that it is difficult for the world to know how much Yemen is suffering. Only by speaking to the few who have managed to flee can even begin to grasp the realities of daily life for those left behind.

*Names have been changed to protect the identities of our sources.

Neha Shah has been volunteering in the Calais camp.