The Supreme Court handed President Barack Obama a major victory Thursday when the justices voted 6-3 to uphold the administration’s interpretation of a key provision of the Affordable Care Act. The decision means that millions of Americans who were at risk of losing their health insurance if the court had ruled against the act will be now allowed to keep their coverage. And it all but assures that the president’s signature health care legislation, which Republicans have repeatedly tried and failed to undermine, is effectively here to stay.
The case before the court, King v. Burwell, hinged on a single, relatively obscure phrase buried in the nearly 1,000-page law in a section covering people who receive tax credits to offset the cost of purchasing health insurance in the 37 states where the federal government set up health insurance exchanges after state officials refused to establish such marketplaces themselves. The contested language in that phrase occurred in a passage that seemed to suggest that the subsidies were available only to people buying insurance on “an exchange established by a state.”
The four plaintiffs in the case, who were represented by a conservative group that opposes the health care law, argued that the Internal Revenue Service therefore could not legally offer subsidies to people who bought health insurance on a federal, rather than a state, exchange. Since almost all of those who purchase coverage on the federal exchanges could not afford to do so without the subsidies, a ruling in the plaintiffs’ favor would have immediately caused millions of people to lose their coverage under the law and brought about the financial collapse of the health insurance markets in those states.
In writing for the majority, Chief Justice John Robert’s acknowledged the ambiguity contained in what he called the “inartful drafting” of the phrase at issue. But he went on to say that its meaning must be interpreted within the overall context of the law. Because Congress clearly intended the act to apply to people who bought insurance coverage on both the federal and state exchanges, the court should cede to the government’s argument that they were all equally eligible for federal subsidies as well.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he wrote. “If at all possible we must interpret the Act in a way that is consistent with the former, and avoids the latter.” He was joined in that opinion by Justices Anthony M. Kennedy, Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan. Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. dissented.
Republicans lost little time in denouncing the decision. Senate Majority Leader Mitch McConnell warned the president not to “crow” about victory, adding that “today’s ruling won’t change Obamacare’s multitude of broken promises, including the one that resulted in millions of Americans losing the coverage they had and wanted to keep.” In coming days we can expect to see a chorus of GOP presidential candidates lining up to throw cold water on the president’s victory. Some already are calling for embracing a complicated procedural scheme known as “reconciliation” to sabotage the law later this year.
But Republicans also may be secretly relieved the court upheld their nemesis; if the justices had struck down the ACA they would have found themselves in the awkward position of having to come up with real alternatives to replace it rather than the ritual denunciations they’ve offered so far.
The case is likely to be the last serious legal challenge to the Affordable Care Act for the foreseeable future. Shortly after the decision was announced, Obama held a press conference in which he praised the court’s ruling and called on lawmakers of both parties to work together to further strengthen the nation’s health care system.
He also acknowledged the historic significance of the act as a continuation of a decades-long social welfare movement that included the creation of Social Security and Medicare. “After nearly a century of talk, decades of trying, a year of bipartisan debate, we finally declared that in America, health care is not a privilege for a few but a right for all,” he said. Couple this with Congress’ passage of legislation giving Obama authority to negotiate a trade pact with Asia and the president can say this has been a very good week for him — and the American people.
— The Baltimore Sun
