In a 6-3 decision announced Thursday morning, the U.S. Supreme Court ruled in King v. Burwell that federal healthcare subsidies under the Affordable Care Act—a.k.a. Obamacare—are legal in all states, not just those with their own state-run insurance exchanges.
Obamacare opponents pointed to language in the bill that allowed the tax subsidies for “exchanges established by the state,” arguing that the 34 states that defaulted to the federal exchange—healthcare.gov—weren’t eligible. If the Court had accepted their argument, it would have effectively removed access to Obamacare for more than six million people.
Justice Antonin Scalia summed up their argument in his dissent (joined by Justices Thomas and Alito), writing: “Words no longer have meaning if an Exchange that is not established by a State is ‘established by the State.’ 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.’ And it is hard to come up with a reason to include the words “by the State” other than the purpose of limiting credits to state Exchanges.”
But the prevailing argument was that the meaning of those words has to be considered in context, and to interpret the statute as narrowly as the plaintiffs (and Scalia) would have liked would essentially be to rewrite the ACA—not the Supreme Court’s job.
“While the meaning of the phrase ‘an Exchange established by the State under [42 U. S. C. §18031]’ may seem plain ‘when viewed in isolation,’ such a reading turns out to be ‘untenable in light of [the statute] as a whole,’” Chief Justice John Roberts wrote for the majority.
Obamacare survives this latest challenge as written (and, more importantly, as intended).
[Photo: AP Images]