Five years ago, President Obama and Congressional Democrats disregarded both the Constitution and the opinion of the American people when they enacted ObamaCare. Since then, Americans have seen the law transition from political to personal. Many have lost access to their longtime doctor. They lost the insurance plan they were happy with. They pay higher premiums or a higher deductible. Maybe it cost them their job, maybe it cost them hours at work, or maybe they’re suffering from all of the above.
As the legislation has been implemented over the last five years, the cracks in the final bill have expanded one by one into full scale crises. President Obama has attempted to patch these problems by writing new rules and regulations on the fly, often with questionable constitutionality. But soon his days of bypassing federal law and the Constitution may catch up to him, and to all of us.
If you like your health insurance plan, you actually might have been able to keep it this year.
Fewer than 1 million Americans had their health insurance plans canceled for 2015 for noncompliance with Obamacare rules, according to a report by the Urban Institute and Robert Wood Johnson Foundation.
The report, which called that number “quite small,” suggests that in the latest enrollment season there was relatively little disruption of either the individual or job-based insurance market due to plans not meeting Affordable Care Act-related regulations.
Those rules set certain minimum standards for coverage, including prescriptions, maternity care and mental health treatment, which were not required in plans prior to the ACA’s enactment.
If the Supreme Court in King v. Burwell strikes down subsidies to the buyers of health insurance on the federal exchange, President Obama will call on Congress to change the law to allow the subsidies. There also will be enormous pressure on elected officials to establish state exchanges in the 34 states that don’t have them. Instead, congressional Republicans should be laying the groundwork for market-friendly health reforms and devolving power to the states, meanwhile helping Americans who have difficulty purchasing coverage…
One of the most anticipated cases of the Supreme Court’s 2014-2015 term is King v. Burwell. In it, the Supreme Court is confronted with what should be a straightforward question of statutory interpretation about the scope of subsidies available under the Affordable Care Act (ACA). Section 1311 of the ACA states that “each state shall, not later than January 1, 2014, establish an American Health Benefit Exchange.” Another part of the law, section 1321, then qualifies that apparently absolute duty by providing that if the state does not “elect” to establish that exchange by January 1, 2014, or if it otherwise fails to meet the federal requirements for an exchange, “the Secretary [of HHS] shall . . . establish and operate such exchange within the state.”
The question of whether a state establishes this exchange determines far more than where individuals can buy their health care coverage. It also determines whether any purchaser of health insurance is entitled to a tax credit against his or her cost of coverage, as that subsidy is limited to taxpayers who are enrolled in a qualifying plan “through an Exchange established by the state” under Section 1311. Internal Revenue Service regulations interpreted the ACA requirement so that its tax subsidies were available to all individuals whether they enrolled in an exchange established by the state or by HHS when the state elected or failed to do so. The plaintiffs’ challenge to the regulation was in essence that the plain language of the ACA precluded the IRS from expanding the scope of the subsidy by this sleight of hand. King would have been an open-and-shut victory for the plaintiffs if the disputed interpretation had been some run-of-the-mill tax provision. But 36 states did not establish these exchanges because they wanted to guarantee their citizens the statutory tax breaks.
Today, the Supreme Court heard oral arguments in King v. Burwell, a case with significant implications for the future of Obamacare. Most of the justices’ questions proceeded along expected lines. Most notable was a series of questions by Associate Justice Anthony Kennedy, who questioned whether it would be constitutional for Obamacare to induce states to set up exchanges. If Kennedy’s fears are right—that federal subsidies for state-based exchanges are “coercive”—then he might side with the Obama administration in the case. But if you understand how Obamacare’s insurance markets work, it’s clear that Kennedy should side with Obama’s challengers.
Congress is busily making plans for legislative action should the latest challenge to Obamacare prevail in the Supreme Court.
On Wednesday, the justices will hear arguments in King v. Burwell to decide whether the IRS had the authority to write a rule authorizing subsidies to go to millions of people in the 37 states with federal exchanges.
The plaintiffs say the language of the law is clear: Subsidies are allowed in “an Exchange established by the State under [section] 1311of the Patient Protection and Affordable Care Act.” It doesn’t just say this once, but nine times in various linguistic forms.
That is the point that MIT economist Jonathan Gruber made when he famously said: “If you’re a state, and you don’t set up an exchange, that means your citizens don’t get their tax credits.”
The day of reckoning for President Obama’s lawless rollout of Obamacare finally will arrive this week when the Supreme Court hears oral arguments in King v. Burwell. Americans who are interested in the rule of law should hope that when the SCOTUS hands down its decision–most likely on the very last day of the term this June–it will rule to enforce the law that was actually written, not the law the IRS wishes had been written. But those like me who are interested in good health policy are looking forward to an important side-benefit of such a principled decision. It finally may give us a crude market test for a poorly conceived and badly marketed product that so far has survived only because it has a federally enforced monopoly behind it.
By our count at the Galen Institute, more than 49 significant changes already have been made to the Patient Protection and Affordable Care Act: at least 30 that President Obama has made unilaterally, 17 that Congress has passed and the president has signed, and 2 by the Supreme Court.
As we approach oral argument this week at the Supreme Court in the King v. Burwell case, critics of the latest legal challenge to an Affordable Care Act provision are predicting a disaster of biblical proportions if the Court overturns an IRS rule and declares as illegal the current insurance subsidies for coverage in health exchanges established by the federal government.
This endless loop of major media reporting seems to be taking its cues from the original Ghostbusters movie script. “Fire and brimstone coming down from the skies! Rivers and seas boiling! Forty years of darkness! The dead rising from the grave! Human sacrifice! Dogs and cats, living together! Mass hysteria!” But only the “mass hysteria” part may be accurate for some of those news and commentary outlets.
By Orrin Hatch, Lamar Alexander and John Barrasso
Wednesday, the Supreme Court will hear oral arguments about whether the Obama administration used the IRS to deliver health insurance subsidies to Americans in violation of the law. Millions of Americans may lose these subsidies if the court finds that the administration acted illegally. If that occurs, Republicans have a plan to protect Americans harmed by the administration’s actions.
When the court rules in King v. Burwell, we anticipate that it will hold the administration to the laws Congress passed, rather than the laws the administration wishes Congress had passed, and prohibit subsidies in states that opted not to set up their own exchanges, as the language in the law clearly states. Such a ruling could cause 6 million Americans to lose a subsidy they counted on, and for many the resulting insurance premiums would be unaffordable.
Republicans have a plan to create a bridge away from Obamacare.
First and most important: We would provide financial assistance to help Americans keep the coverage they picked for a transitional period. It would be unfair to allow families to lose their coverage, particularly in the middle of the year.