David King, a resident of the state of Virginia along with 3 other fellow Virginians filed suit against the Internal Revenue Service over what they believe is 11 unconstitutional words in the Affordable Care Act. This obscure case, backed by political opportunists, made its way through the federal courts of appeal to the Supreme Court. Oral arguments were heard in early March.
The premise of multiple legal briefs is that the language in the Affordable Care Act (ACA) states that “federal subsidies are limited to states that established their own health insurance exchange.” In short, a state such as Texas, who did not establish and run its own health insurance exchange, does not have the legal authority to provide subsidies to Texans. Ergo, the IRS cannot penalize Mr. King and his friends for not having health insurance.
Proponents of the ACA say this is a ludicrous interpretation of the law whose intent clearly was not what the plaintiffs claim. Legal scholars argue there is not legal “standing” of infringement of constitutional rights as Mr. King and one other plaintiff are veterans and therefore qualify for VA health services. The remaining other plaintiffs are reported to be Medicaid eligible, therefore no harm was done by the ACA. Therefore, there is no legal standing for its merit.
If, however, Chief Justice Roberts and the Supreme Court find for Mr. King, the law would be therefore repealed as it has been ruled unconstitutional. What then of the 16.1 million enrollees who now have health insurance, many of whom reside in states who did not create a health insurance exchange and are receiving monetary relief to lower the insurance premiums?
We must wait until June for the “Chief” as he is called to release the court’s decision. I believe they will not find in favor of the plaintiffs. I suggest there is legal precedent for the court to dismiss the charge because it fails to meet the burden of standing and avoid a legal opinion rendered by the Supreme Court impacting U.S. healthcare law. But, we will see.
This case calls, rather, begs for the need for further amendments to the ACA to ensure its legacy and lasting impact on the health of millions of Americans. Given the current political reality of Washington I do not believe this will happen in the coming months or year. Unfortunate, but true.
There are a several inaccuracies in the article.
The 11 words in question are not being challenged as unconstitutional. Rather, the case says the IRS, by offering subsidies in states that do not operate their own exchange, is not following the ACA, and must stop offering subsidies in those states.
If the Court rules in favor of King, the law will not have been found unconstitutional, and will not be repealed. All that will happen legally will be that the IRS will be forced to change its regulations allowing subsidies in every state.
The case is not about the constitutionality of the law, or even the subsidies. It is about the IRS doing whatever it wants regardless of the law.
While proponents of the ACA claim it was never the intent of the law to exclude anyone from a premium subsidy, the man that wrote the law differs. He has claimed publicly, and repeatedly that it was, in fact, the intent of the law to exclude residents of states that did not create an exchange from receiving subsidies. It was blackmail, of sorts, to guarantee that every state would create its own exchange. They reasoned that no state would be foolish enough to block premium subsidies from their residents. In fact, the framers of the bill were so certain of this that they did not include ANY funding for healthcare.gov since it would not be needed.
However, when the IRS announced that they were going to make subsidies available to everyone in the country, 36 states that did not support the ACA elected to forgo the expense of creating and operating an exchange.
Regarding ‘standing’ of the plaintiffs in the King case – standing has already been granted by the Court, otherwise, it would not have wasted its time hearing the case. The Court may have looked past the normal rules of standing to fast track the case. Since it addressed an important issue they would have to hear eventually, they decided it was better to hear it sooner rather than later.
If the Court rules in favor of King, the implementation of the law will be damaged, but not destroyed.
A few states, anticipating a King victory, have begun the process of creating an exchange. Congress, anticipating the possibility of a King victory, has begun hammering out a plan to address the needs of those that will lose subsidies.