King v Burwell: Supreme Court upholds Affordable Care Act

The Washington Post provided this overview of the Supreme Court ruling in King v. Burwell.

In considering the health-care law, the justices were asked to interpret a passage that said the tax credits are authorized for those who buy insurance on marketplaces that are “established by the state.”

But federal exchanges were authorized for states that did not set up their own, and the Obama administration argued that millions of people served by a federal marketplace were entitled to the subsidies, too.

The court agreed that that was the only way the law would work and that, although the legislation’s wording was problematic, Congress’s intent was clear.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible we must interpret the Act in a way that is consistent with the former, and avoids the latter,” Roberts wrote.

Joining the chief justice in the majority were Justices Anthony M. Kennedy, Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan. Opposing the decision were Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr.

Find the entire article by Robert Barnes here: http://www.washingtonpost.com/politics/courts_law/obamacare-survives-supreme-court-challenge/2015/06/25/af87608e-188a-11e5-93b7-5eddc056ad8a_story.html?wpisrc=nl_politics&wpmm=1.

A brief analysis of the votes reads:

In the 6-to-3 decision, Chief Justice John G. Roberts Jr. delivered a sympathetic affirmation of what has become known as Obamacare, and his legal reasoning seemed to insulate the 2010 law against the legion of opponents who want to undermine the program before it takes hold in American life.

Kennedy’s position in the majority was particularly significant. In 2012, he was one of four justices who would have found the entire law unconstitutional.

Scalia said Roberts, who wrote the decision in 2012 that saved the Affordable Care Act from that challenge, has performed “somersaults of statutory interpretation” to preserve the law.

“We should start calling this law SCOTUScare,” he said. The comment drew laughter as Scalia emphasized his disagreement with the decision by reading part of his dissent from the bench.

The two cases, Scalia said, “will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”

Chief Justice John Roberts wrote for the majority.  Here is the Post analysis:

There seemed to be a different tone to Roberts’s opinion this time. In 2012, he distanced the court from the legislation, writing, “It is not our job to protect the people from the consequences of their political choices.”

But in Thursday’s opinion, the language was more sympathetic. The complicated program “grew out of a long history of failed health insurance reform,” Roberts noted. He added that it was designed “to ensure that anyone who wanted to buy health insurance could do so.”

He acknowledged the disjointed way the law was written. It “contains more than a few examples of inartful drafting. . . . Congress wrote key parts of the act behind closed doors, rather than through the traditional legislative process,” Roberts wrote.

But rather than simply focusing on the phrase “established by the state,” Roberts said the court had to look at the intent of the entire law.

“The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any state with a federal exchange, and likely create the very ‘death spirals’ that Congress designed the act to avoid,” Roberts wrote.

He rejected the challengers’ argument that Congress intended to give the states an incentive to create their own exchanges.

To agree, Roberts said, would require rewriting the statute. “The states likely would have created their own exchanges in the absence of the IRS rule, which eliminated any incentive that the states had to do so.”

Some legal experts had thought the court might find the law ambiguous and thus simply uphold the Internal Revenue Service rule that said those who buy insurance on the federal exchange are entitled to the subsidies, in the form of tax credits, just as those who buy on a state exchange are. The court’s precedents call for deference to an agency when the law is unclear.

But crucially, Roberts said this was not a decision for an agency to make. He said the court needed to look at the law as a whole and concluded that even though the legislation’s language might be murky, its intent was clear.

Find the opinion here: https://kaiserhealthnews.files.wordpress.com/2015/06/kingvburwell-decision.pdf.