The Patient Protection and Affordable Care Act of 2010 started at about 1,000 pages, even before federal agencies started building the paperwork mountain of regulations to implement the dramatic change known as “Obamacare.”
Since then, millions of Americans signed up in good faith for insurance via the federal exchange set up by the law — although many states had set up their own exchanges, also per the law.
After all that, was it very reasonable to expect the U.S. Supreme Court to strike down the insurance subsidies on the federal exchanges based on four words in the statute that conflicted with other parts of the vast law?
The justices said in a 6-3 ruling Thursday that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live. The plaintiffs had based their argument on one section of the law that said subsidies would be granted only for exchanges “established by the state.” Louisiana and many other states did not establish their own exchanges.
The ruling is based on precedent more than politics. In earlier rulings, the high court has said that when a law is ambiguous, justices should defer to reasonable decisions made by federal agencies to implement the law.
In Louisiana, more than 130,000 policies were issued by private insurers through the federal exchange. Withdrawing the subsidies might not have directly eliminated all of those private policies, but it certainly would have made many of them unaffordable for families.
Chief Justice John Roberts noted that “destroying” insurance markets was not the intent of the overall law, and in that context Thursday’s decision in King v. Burwell represents a court that is not legislating from the bench, as some Republicans immediately asserted.
Even President Barack Obama, though, conceded immediately that more work is needed to achieve the laudable goal of wider insurance coverage.
We welcome the Republican alternatives now under development — particularly those by U.S. Sen. Bill Cassidy, of Baton Rouge, and U.S. Rep. Charles Boustany, of Lafayette, both physicians — to generate a further debate on the ways and means to provide health care in this country. “The Supreme Court’s decision does not repeal the problems with Obamacare,” Cassidy said Thursday.
And if Democrats celebrate a bit today, they ought to remember who passed amid haste the bill whose flaws were called into question, all the way up to the Supreme Court.
Then-Majority Leader Nancy Pelosi, of California, famously said to pass the bill and read it later.
Some of the court’s time might have been saved had the order of that advice been reversed.