In the past year or so the King v Burwell lawsuit has dominated health care reform discussions, both because of the novelty of the argument, the surprise success it attained in reaching the Supreme Court in the first place, and because the practical implications of a win for the plaintiffs would’ve threatened insurance subsidies for up to 6.4 million Americans in an ensuing market death spiral within states that utilized federal insurance marketplaces. Many, many thousands of words have been written about this subject, but to be brief King advocates argued that four words alone in the Affordable Care Act’s legislation — irrespective of whatever else the law intended — meant that residents of a state that did not establish its own exchange could not receive financial assistance to purchase insurance policy through Healthcare.gov.
Today the Supreme Court, in a 6-3 decision for the government, disagreed. In my understanding of how this has all played out: moral and judicial sanity walked up to the cliff, took a glimpse downward at the bone-strewn chasm of taking a really silly and inhumane idea seriously, and effectively replied “Nah, not today.”
In the Chief Justice’s own words:
Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.
It was a plain reading of the law’s intent, rather than a plain reading of a few words absent any context. This blanket acceptance also disallows any future administration from directing the IRS from reinterpreting the question (which prompted the the original legal challenge from King). While this won’t prevent states from using another administrative workaround to bypass some of the law’s provisions with the blessing of a Republican executive branch, conjecture among health care reform and legal folks indicates this may have been the last serious systemic challenge against Obamacare.
So, at some point, many of us having been wanted to state unequivically that the post-ACA status quo is here to stay. We may have finally reached that moment. Now let’s continue to work on expanding that coverage to the millions of working poor Americans who are still left behind.