The Affordable Care Act narrowly escaped a judicial decision that would have shrunk its reach Thursday when the Supreme Court ruled the IRS could continue distributing insurance subsidies nationwide. Now, with the law no longer under an immediate meaningful threat of repeal, some are looking to stretch Obamacare further.
Specifically, governors in several states are renewing their push to expand Medicaid, hoping to bring the federal low-income health insurance program to more of their state’s residents.
Despite the Supreme Court decision to uphold the subsidies for private insurance in King v. Burwell, the fundamental problems with the Affordable Care Act remain. Ironically, it is the growing government centralization of health insurance at the expense of private insurance that must be addressed.
Republican leaders vowed to continue their effort to dismantle Obamacare after the Supreme Court ruled for the Obama administration in King v. Burwell, while acknowledging that repealing and replacing the law is extremely unlikely while President Obama is in office.
The Supreme Court ruling upholding subsidies on the federal health-insurance exchange may prompt state-run exchanges to forge regional networks or use the federal marketplace.
Many of the dozen states operating exchanges under the Affordable Care Act are encountering financial strains, and could join the three dozen states already using the federal marketplace, HealthCare.gov. Some policy experts say it’s possible most of those states will eventually do just that, creating a largely national exchange program.
While most of the reaction to the Supreme Court’s decision in King v. Burwell has centered on the political victory for the president and the various winners and losers from the decision itself, a more far-reaching consequence has received much less notice. The legal dispute hinged around whether a law means what it says, or means what someone reading later – say, an admistration official – thinks it must have really meant, or prefers it would have meant. More generally, however, the issue raised is whether laws passed by Congress have to be administered as written, or whether a President can change the law it will in whatever what he or she thinks will be better.