Supreme Court Set to Decide Another Affordable Care Act Challenge

In April, the United States Supreme Court conducted oral arguments on a key provision of the Patient Protection and Affordable Care Act (“ACA”) that may impact up to 8 million policy holders.  The case, King v. Burwell, presents the issue as to whether the law makes people in all 50 states eligible for federal tax subsidies or just those who live in states that created their own health insurance marketplaces.  At the time of the argument, approximately three dozen states opted against establishing their own marketplace and instead rely on the United States Health and Human Services Department’s Healthcare.gov.

Specifically, the law provides that the health insurance subsidies are available to individuals who purchase insurance “through an Exchange established by a State.”  The Supreme Court is charged with deciding whether the statutory language allows individuals in states that utilize Healthcare.gov to obtain the subsidies.  If the Court determines that they are not, insurance subsidies for people in those states would be in jeopardy.  As expected due to the divisiveness of the ACA, both sides possess strong feelings on the issue.

Opponents of the ACA stress the importance of applying the plain meaning of the statute.  Specifically, they provide, that the words are clear proof that Congress wanted to limit subsidies to those consumers who get their insurance through a marketplace that was established by a state rather than Healthcare.gov.

On the other hand, proponents of the ACA disregard the plain language of the statute and instead focus on Congressional intent.  Namely, they assert, that the ACA was enacted to provide flexibility for a state to either set up their own marketplace or rely on the federal Healthcare.gov.  Thus, they assert, it would be contrary to Congress’ intent to later rule that insurance subsidies are unavailable to states that elect the latter.

The likely outcome of King v. Burwell is difficult to predict.  As expected the questions presented by the liberal wing of the Court at oral argument, led by Justice Ruth Bader Ginsburg, seem to indicate that their position lies with the proponents of the healthcare law.  Contrarily, the conservative wing, with Justices Alito and Scalia at the helm, sent indications of the opposite result.  The likely swing votes lie with Justices Kennedy and Roberts.  The issue will be resolved later this month, when the Court issues its much anticipated decision.

Aaron Caskey is an attorney in the law firm of Dressman Benzinger LaVelle, with offices in Cincinnati, Ohio, Crestview Hills, Kentucky, and Louisville, Kentucky.