For 1 Million Floridians, Health Insurance Again in the Balance as Supreme Court Rethinks Subsidies
FlaglerLive | November 10, 2014
Close to 1 million Floridians have enrolled in the Affordable Care Act better known as Obamacare, in the state which had the second-highest rate of uninsured Americans after Texas.
The average subsidy for Florida’s beneficiaries of the Affordable Care Act is $3,000 apiece.
Enrollment and subsidies are now at risk, because once again, the Supreme Court will decide whether the Affordable Care Act lives or dies.
Defying expectations, the court announced Friday it has agreed to hear – during this term – a case that challenges the heart of the law: subsidies to help people pay their insurance premiums. In about three dozen states, the federal government runs the online marketplaces where individuals can find health plans.
At issue is a phrase in the law stipulating that subsidies to help those with incomes under 400 percent of poverty are available only in “exchanges established by a state.” The authors of the law argue that the rest of the statute makes it clear that subsidies are available not only in state-run exchanges, but in those where the federal government is doing the work of the state.
When the law was written, most people–and lawmakers–expected that states would want to run their own exchanges. It was a surprise when most opted to let the federal government do it instead. Florida was among those states as Gov. Rick Scott and a hostile Legislature opposed developing an exchange in the state.
A decision to strike down the subsidies in federally-run exchange states could end up making insurance unaffordable for millions of people and threaten the viability of the law’s entire health insurance program.
If the law is crippled by the elimination of subsidies in states like Florida, the rest of the Affordable Care Act could become untenable, and with it such provisions as the prohibition on insurers to exclude people with pre-existing conditions, or the prohibition on lifetime benefits caps, or the requirement that health plans provide a minimum standard of coverage.
In a rare Friday afternoon notice following their closed-door conference, the justices noted with no further comment that they have agreed to hear King v. Burwell. That is the case in which a three-judge Appeals Court panel in Richmond ruled unanimously that Congress did intend to allow subsidies to be available nationwide.
That same day, a panel in the District of Columbia Court of Appeals ruled 2-1 the opposite way. But that case, Halbig v. Burwell, was vacated when the full court agreed to rehear the case. That is scheduled for December. Because there are not yet contradictory decisions by appeals courts, most observers thought the Supreme Court would at least wait until the lower courts were finished considering the case before weighing in.
“We are disappointed that at least four Justices decided to hear this case despite the lack of a circuit split and while this issue is still being actively litigated in the lower courts,” said Doug Kendall of the Constitutional Accountability Center, which is representing the members of Congress who wrote the law. “But we remain very confident that the Court will ultimately find that both the text of the ACA and the intentions of Congress mandate a ruling for the federal government.”
–FlaglerLive and Kaiser Health News