Supreme Court Upholds Subsidies|Under the Affordable Care Act

     (CN) – The Supreme Court on Thursday upheld the nationwide tax subsidies that are a key component of 2010 Patient Protection and Affordable Care Act, averting the collapse of President Barack Obama’s signal legislative achievement.
     Speaking to reporters at the White House shortly before noon, President Obama called the ruling a “victory for hard-working Americans.”
     “The Affordable Care Act is here to stay,” the president said.
     The 6-3 ruling is the second that Chief Justice John Roberts has written in the past three years that helped bolster a health care law that has been a constant target of Republican attacks in Congress. Roberts was notably silent when the high court heard oral argument on the case in March.
     Although the court majority acknowledged that the law was unfortunately ambiguous in stating that subsidies are available only to those buying insurance on “an exchange established by the state,” Roberts held that Congress clearly intended to provide subsidies in all 50 states, not just the 16 that have established their own insurance exchanges.
     “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote. “If at all possible, we must interpret the Act in a way that his consistent with the former and avoids the later.”
     In a statement, Health and Human Services Secretary Sylvia Burwell said as a result of the Supreme Court’s decision, “Over six million Americans and their families will sleep easier knowing they will still be able to afford health coverage.
     “Millions more won’t have to worry about an upward spiral in their premiums because of today’s decision, even if they didn’t buy their insurance through the Marketplace. And the law’s financial assistance will be available in the next open enrollment so that others can benefit as well,” Burwell said.
     But House Speaker John Boehner said he and his Republlican congressional colleagues will continue to try to repeal the law and replace it with what he described as “patient-centered solutions that meet the needs of seniors, small business owners, and middle-class families.”
     The case before the justices was King v. Bruwell, in which four plaintiffs from Virginia sued the Obama administration, arguing that as written the law forbid the federal government from proving subsidies in states that do not have their own exchanges.
     Specifically, the plaintiffs took issue with an Internal Revenue Service regulation – an enabling rule meant to implement the health care law – that said subsidies were allowed whether a health insurance exchange was run by the federal or state government.
     The Obama administration responded by arguing that Congress never would have deliberately imposed such a limitation. With some 7 million Americans having already bought insurance through the exchanges, tossing the subsidies now would create chaos, the government argued. Congressional Democrats took a similar position in an amicus brief filed with the court in January.
     The U.S. District Court dismissed the suit, holding that the act unambiguously made tax credits available to individuals enrolled through a federal exchange.
     When the Fourth Circuit affirmed that ruling last year, it conceded that the health care law’s language on subsidies was subject to “multiple interpretations,” but that the Internal Revenue Service’s interpretation of the Affordable Care Act deserved deference.
     On the same day, however, a divided D.C. Circuit panel invalidated the IRS regulation.
     In upholding the subsidies Thursday, Roberts said the Affordable Care Act “contains more than a few examples of inartful drafting.”
     “Several features of the act’s passage contributed to that unfortunate reality,” he continued. “Congress wrote key parts of the act behind closed doors, rather than through ‘the traditional legislative process.’ … And Congress passed much of the act using a complicated budgetary procedure known as ‘reconciliation,’ which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement.
     “As a result, the act does not reflect the type of care and deliberation that one might expect of such significant legislation,” the chief justice wrote.
     Roberts was joined in the majority by Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor, Stephen Breyer and Elena Kagan.
     Ultimately, “a fair reading of legislation demands a fair understanding of the legislative plan,” the decision states.
     In this case, the plan was to enhance and improve health insurance markets, and the provision of the law in question “can fairly be read consistent with what we see as Congress’s plan,” Roberts wrote.
     “That is the reading we adopt,” he added.
     Justice Antonin Scalia described the majority’s interpretation as “absurd” in a caustic dissent, joined by Justices Clarence Thomas and Samuel Alito.
     “Words no longer have meaning if an exchange that is not established by a state is ‘established by the state,'” he wrote. “It is hard to come up with a clearer way to limit tax credits to state exchanges than to use the words ‘established by the state.'”
     Alluding to the “Obamacare” nickname for the Affordable Care Act, the dissent angrily suggests “we should start calling this law SCOTUScare.”
     “Perhaps the Patient Protection and Affordable Care Act will attain the enduring status of the Social Security Act or the Taft Hartley Act; perhaps not,” Scalia wrote. “But this court’s two decisions on the act will surely be remembered through the years.
     “The somersaults of statutory interpretation they have performed … will be cited by litigants endlessly, to the confusion of honest jurisprudence,” Scalia concluded. “And the cases 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.”

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