Sometime in the next few weeks, the U.S. Supreme Court will rule on whether the federal government can subsidize people’s health insurance in the 37 states that haven’t set up Affordable Care Act exchanges. Behind that fight is another one, just as interesting and almost as important: Who gets the blame if the government loses?
The case, King v. Burwell, revolves around a phrase in the law that says insurance subsidies are available on exchanges “established by the state.” The plaintiffs and their supporters say this shows Congress meant to use the subsidies as a cudgel to compel states to create their own exchanges. Now that the strategy has failed, they argue, with some states refusing to build exchanges and instead defaulting to the one run by the federal government, the government should accept the consequences and withdraw those subsidies.
