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Is Ted Cruz Writing the Script to His Own Obamacare Horror Story?

Darren McCollester/Getty Images

Texas Senator Ted Cruz is officially a presidential candidate, and his wife has taken unpaid leave from Goldman Sachs to help him run his campaign, which means her employer-sponsored family health plan will sit in abeyance and the Cruzes will enroll in insurance, like most members of Congress, through an Affordable Care Act exchange.

The development elicited predictable, but ill-conceived recriminations from critics when schadenfreude and a moment of reflection would have been more appropriate responses.

But there is something strange about Cruz’s decision to enroll in Obamacare, and we can deduce it from two things he told CNN when the news broke.

First he said: ”We'll be getting new health insurance, and we'll presumably do it through my job with the Senate, and so we'll be on the federal exchange with millions of others on the federal exchange.”

And then he said: "I believe we should follow the text of the law.”

These might sound like trivialities, verging on platitudes, but together they point to a puzzling decision. Cruz’s determination to sign up for Obamacare, and the way he’s choosing to do it, may be politically driven after all.

Cruz insisted multiple times that he and his family will be “on the federal exchange,” which suggests he’ll enroll on in Texas’ marketplace. But the new benefit system for members of Congress isn’t really optimized for Cruz to be on the federal exchange “like millions of others.” It’s set up for members to enroll through Washington, D.C.’s small group market. In fact, that’s the only way for members to avail themselves of their employer’s contribution to their premiums.

Like many Republicans, Cruz will decline that contribution. Indeed, when he says, “we should follow the letter of the law,” he’s referring to a common conservative claim that the ACA’s bill text doesn’t allow the federal government to subsidize member premiums at all. That probably explains why Cruz keeps referring to “the federal exchange” instead of D.C.’s Health Link.

But when he says “we should follow the letter of the law,” he’s also referring to King v. Burwell, a Supreme Court case that threatens to void ACA subsidies in 36 states (like Texas) that have federally facilitated exchanges because they declined to set up their own.

The threat to subsidies in Texas doesn’t affect Cruz directly. His family isn’t eligible for them. But if the Court rules for the King challengers in June, it won’t simply eliminate other people’s subsidies. It’ll push hundreds of thousands of Texans off of their plans, and eviscerate the law’s coverage requirement, ruining the individual and small group markets in Texas, where the Cruzes’ insurance will be based. Plans will disappear and costs will spike for almost everyone—even those who weren’t previously eligible for subsidies.

Cruz knows this all extremely well. He’s one of six Republican senators who submitted an amicus brief to the Supreme Court on behalf of the King challengers, asking the justices to wipe out tax credits in three dozen states. Which is to say, he’s signing his family up for health insurance in a market he wants the Supreme Court to destroy.

Neither the federal Office of Personnel Management, which administers insurance benefits for members of Congress, nor Cruz’s press secretary, responded to email inquiries about this unusual arrangement. But it’s easy to imagine why Cruz might’ve chosen it.

Yes, his family lives in Texas. If you assume that the Supreme Court will uphold the subsidies, then it makes sense for him to pick a plan with a good local provider network in Houston. But it doesn’t make much sense for him, in terms of his health and finances, to purchase insurance in Texas while simultaneously asking the Supreme Court to send the Texas insurance market into a death spiral of adverse selection.

Perhaps Cruz is disclosing in the most roundabout possible way that he no longer believes the Court will or should eliminate ACA subsidies in Texas and elsewhere. More likely he thinks he can turn his family’s own travails with Obamacare to his advantage on the campaign trail this summer. If his plan gets canceled or his premiums mushroom after a bad Court ruling in June, he can play up his own Obamacare horror story to frothing Republican primary voters, while omitting the fact that he quite literally asked for it.