A project of the Galen Institute

Issue: "Liberty & Limited Government"

Republicans Will Run On An Obamacare Replacement in 2016 – Will Democrats?

Ben Domenech for Morning Consult
Sat, 2014-07-26
"The decision in the Halbig v. Burwell case this week was an unexpected legal boon to opponents of Obamacare. Spearheaded by the Cato Institute’s Michael Cannon and law professor Jonathan Adler, the case will almost certainly lead this debate about the text of the Affordable Care Act back to the Supreme Court. My colleague Sean Davis has written a comprehensive piece on the case, particularly on the nature of the supposed “drafting error” at its core. But whatever the ultimate outcome for Halbig, the case serves as a reminder of the uneven ground on which Obama’s health care law is likely to be standing over the next two years.

The Stakes Beyond the Halbig Lawsuit

Drew Altman for Wall Street Journal
Fri, 2014-07-25
"A lot of attention is being paid to the dueling decisions in two U.S. appeals courts about whether the U.S. government can provide tax credits to people in federal- as well as state-run insurance exchanges. In human terms, the stakes are high: Millions of moderate-income people will not be able to afford health coverage without a subsidy, and a court ruling could gut coverage expansion in the 36 states with federally run insurance exchanges, unless states decide to set up their own exchanges. One of the cases, Halbig v. Burwell, also adds uncertainty to the enrollment process set to begin this fall, when millions more people are expecting to get tax credits–and wondering if they may be taken away. Amid the reaction, little attention has been paid to whether Americans will perceive Halbig as a legitimate legal question or as more inside-Washington politics. The plaintiffs paint this as a case about statutory language and intent.

Obamacare Architect Admitted in 2012 States without Exchanges Lose Subsidies

Ryan Radia, Competitive Enterprise Institute
Thu, 2014-07-24
"This week, an unprecedented circuit split emerged in Halbig v. Burwell and King v. Burwell over whether health insurance premium assistance is available in states that didn’t set up health insurance exchanges. Many commentators have since claimed that there’s no way Congress intended to deny premium assistance to residents of the 36 so-called “refusenik” states that have not set up their own health insurance exchanges. But in January 2012, Jonathan Gruber—an MIT economics professor whom the The New York Times has called “Mr. Mandate” for his pivotal role in helping the Obama administration and Congress draft the Affordable Care Act—told an audience at Noblis that: What’s important to remember politically about this is if you're a state and you don’t set up an exchange, that means your citizens don't get their tax credits—but your citizens still pay the taxes that support this bill.

Obamacare Help Was In High Demand, Survey Shows

Kaiser Health News
Wed, 2014-07-23
"Most working people in the U.S. sign up for health insurance in a very straightforward way: a few forms, a few questions for human resources, a few choices of plans. Signing up for Affordable Care Act insurance was nothing like that. It involved questions about income, taxes, family size and immigration status. And in most places in the country, there were myriad choices of plans with subtle differences between them. Guess what? People looked for help on the decision. During the Affordable Care Act’s first open enrollment period, about 10.6 million people received personal help from navigators and other enrollment assisters, according to an online survey of the programs released Tuesday by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) And the assistance was time consuming: 64 percent of the programs reported that they spent an hour to two hours with each consumer on average.

Confused about the health care rulings?

Tony Pugh, McClatchey News Service
Wed, 2014-07-23
"WASHINGTON -- Contrary rulings Tuesday on a key element of the Affordable Care Act by two separate federal appeals courts raise a variety of questions. Q: What happened? A: The U.S. Court of Appeals for the District of Columbia Circuit decided 2-1 that tax subsidies available to help people pay for health coverage through the Affordable Care Act can only be used in the 14 states and in D.C., which run their own insurance exchanges without any help from the federal government. But in a unanimous decision on a similar case a short time later, the 4th U.S. Circuit Court of Appeals in Richmond, Va., ruled just the opposite. Q: Who’s eligible for the tax subsidies? A: Individuals and families who earn between 100 percent and 400 percent of the federal poverty level. For those who enrolled this year, it includes individuals earning $11,490 to $45,960, and a family of four earning from $23,550 to $94,200. Q: Does the D.C.

Here’s What Obamacare’s Authors said They Actually Meant

Emily Badger, Washington Post
Tue, 2014-07-22
"The two contradictory appeals court decisions that cast the future of Obamacare into uncertainty Tuesday morning largely center on a question of intent: When the Affordable Care Act was conceived and drafted, did its creators mean to withhold health care subsidies from people living in states that refused to set up their own exchanges?. This latest legal challenge focuses on four words in the mammoth law authorizing tax credits for individuals who buy insurance through exchanges "established by the States." Thiry-six states declined to set up their own exchanges — far more than the law's backers anticipated — and in those states, consumers have been shopping for health care on exchanges run instead by the federal government. Now the D.C.

Appeals Courts Split On Legality Of Subsidies For Affordable Care Act

Julie Rovner, Kaiser Health News
Tue, 2014-07-22
"Two U.S. Appeals Courts Tuesday reached opposite conclusions about the legality of subsidies in the Affordable Care Act, a key part of the law that brings down the cost of coverage for millions of Americans. In Washington, a three-judge panel at the U.S. Appeals Court for the D.C. Circuit ruled that the Internal Revenue Service lacked the authority to allow subsidies to be provided in exchanges not run by the states. That 2-1 ruling in Halbig v. Burwell could put at risk the millions of people who bought insurance in the 36 states where these online insurance marketplaces are run by the federal government. Judge Thomas Griffith, writing the majority opinion, said they concluded "that the ACA unambiguously restricts" the subsidies to "Exchanges 'established by the state.' " But within hours, a unanimous three-judge panel for the Fourth Circuit in Richmond, Va., ruled exactly the other way in King v.

No, the Halbig case isn't going to destroy Obamacare

Ezra Klein, Vox
Tue, 2014-07-22
"The Halbig case could destroy Obamacare . But it won't. The Supreme Court simply isn't going to rip insurance from tens of millions of people in order to teach Congress a lesson about grammar. As Adrianna McIntyre explains, the Halbig case holds that Obamacare's subsidies are illegal in the 36 states where the federal government runs (or partly runs) the exchange. The plaintiffs rely on an unclearly worded sentence in the law to argue that Congress never intended to provide subsidies in federally-run exchanges and so the subsidies that are currently being provided in those 36 states are illegal and need to stop immediately. The point of Obamacare is to subsidize insurance for those who can't afford it This is plainly ridiculous. The point of Obamacare is to subsidize insurance for those who can't afford it.

After Health Law Rulings, Here Are Possible Next Steps

"Margot Sanger-Katz, NY Times
Tue, 2014-07-22
"We now have two federal appeals courts that have issued conflicting rulings on a major provision of the Affordable Care Act. Those decisions are not the final word on whether residents of some states will be able to continue receiving financial assistance to buy health insurance. Here are some possible next steps:"

What will Obama do on employer mandate?

Elise Viebeck and Benjamin Goad, The Hill
Fri, 2014-07-18
"The White House needs to make a decision soon on whether ObamaCare's controversial employer mandate will take effect in 2015. With the mandate set to take effect in January, businesses are awaiting final word from the administration on whether they will be required to track and report how many of their employees are receiving coverage. Federal officials are late in delivering the final forms and technical guidance necessary for firms to comply, raising suspicions the mandate could once again be delayed. The mandate has been pushed back twice before, the first time in late summer. The delays to the mandate have angered House Republicans, who are now taking President Obama to court for what they say is his refusal to follow the letter of the law."

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