Wednesday, March 4, 2015

King v. Burwell: SCOTUS Hears ACA Subsidies Case at the Heart of Health Care

Pretty Graphic Results if SCOTUS
Rules Against the ACA

Let's Hope the Court Does Not Go This Far

United States Supreme Court today in King v. Burwell


The ACA states, in part, that tax credits will be available through the so-called exchanges (online marketplaces), quote: “…established by the State.” Those 4 words are the sticky wicket.

When it was being crafted Congressional lawmakers assumed most or all states would create their own exchanges. After it passed in March 2010, it then became clear that many states would rely on the federal government to operate them as the law allows.

Then in 2012, the IRS issued regulations making the subsidies available in all states. The proverbial shït hit the proverbial fan.

GOP Rightwing challengers (mostly) say those credits cannot be offered in exchanges operated by the Federal government where right now some 34 states have them and thus fall into that category. Without subsidies, insurance costs for low-income Americans would skyrocket.

Those same challengers say that was not simply a drafting error that instead lawmakers purposely made tax credits available only in state-run exchanges as an incentive for governors and legislatures to create their own exchanges (and thus lessen the burden on the Federal taxpayers) – again the crap hit the fan.

From the other side, ACA proponents are backed by some 22 governors and legislatures who argue that they were never told they needed to set up state exchanges in order for their citizens to get tax credits (from the Feds). Maybe a Rick Perry oops needed at that point!!

Further, supporters claim that slant on the issue was not even discussed when the law was being drafted.

So, if the court should take that into consideration then over 8 million Americans would be hurt if the subsidies are eliminated.

Status at the high court today (a bit encouraging): Key question and possibilities:

Q: How bad will we (the court) make things if we rule against the government (shutting off the Fed subsidies)?

Possible Remedies: Justice Kennedy (always a swing vote), seemed decidedly more sympathetic to the government than might have been expected. He seems worried over a constitutional blow against the states. 

Even the two Justices most openly sympathetic to the challengers: Justices Alito and Scalia — seemed to concede the dire consequences that could follow, by suggesting ways to alleviate it: (1) Alito said the Court could delay its ruling to allow time to adjust as they have in past cases, and (2) Scalia said Congress could be counted on to fix it (which they have in the past on other bills).

Sticking point: With this all-GOP congress, itching to repeal the ACA (Obama-care) would or in fact could they be counted on to “fix” it? That is the million-dollar question isn’t it?

Stay tuned – we ain’t done yet (but maybe soon). Then we’ll see who stands with whom on this critical issue. Check back later.

Related to this subject: here from Media Matters and here at my earlier post below.

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