Kaiser Family Foundation
The New York Times Magazine’s recent feature, “Life in Obamacare’s dead zone,” looked at the Medicaid gap we’ve frequently written about since the Supreme Court in 2012 made the ACA expansion optional for states.
The article describes how people who fall into the bizarre coverage gap – in which they are too poor to get subsidized coverage that people just a few slim rungs up the income ladder can get – cobble together care, or just do without, often with pretty grim consequences. Continue reading
When the U.S. Supreme Court ruled in February that the North Carolina State Board of Dental Examiners lacked the authority to regulate teeth-whitening businesses, experts observed that the decision might have impact far beyond the world of dentistry.
Licensing boards regulate hundreds of occupations across the country, everything from medicine and law to bee-keeping and fortune telling. Often the boards are comprised of members of the profession they are regulating. And as in the North Carolina case, there are times when these regulatory bodies run afoul of federal antitrust laws intended to ensure consumer choice and greater access to services. Continue reading
A key issue in King v. Burwell, the health care reform case argued before the Supreme Court in early March, is whether Congress intended to make certain subsidies available to eligible people across the country or only to those living in states that created their own health insurance exchange.
Sam Stein and colleagues at the Huffington Post filed public record requests with several key states, including some in which prominent GOP governors did not establish exchanges. The reporters also reviewed records from the U.S. Department of Health and Human Services and more than 50,000 previously released emails from the Oklahoma governor’s office. The requests covered a period between the March 2010 passage of the Patient Protection and Affordable Care Act and August 2011, when the IRS ruled that the subsidies should be available in all states.
How much discussion did Stein find about the risk of losing subsidies? Continue reading
On March 4 the Supreme Court heard oral arguments in King v. Burwell. A ruling is expected in late June – though it’s possible it could come earlier. The plaintiffs argue that the health insurance subsidies should only be available to people living in states running their own Affordable Care Act health insurance exchanges or marketplaces, not the 34 states using the federal exchange via HealthCare.gov. They cite four words in the text of the law “established by the state” to make this argument. The Administration says it’s clear from reading the full text of the 906 page law that subsidies were to be available in all 50 states, no matter what kind of exchange they have.
By Steve Petteway, Collection of the Supreme Court of the United States (Roberts Court (2010-) – The Oyez Project) [Public domain], via Wikimedia Commons
So the Supreme Court has heard the King v. Burwell challenge to the Affordable Care Act.
Much of the coverage suggested that the March 4 oral arguments seemed to favor the administration, particularly because Justice Anthony Kennedy, often the deciding swing vote on the court, asked some questions showing skepticism of the plaintiff’s case.
But all that tells is precisely that – he asked some questions showing skepticism. He won’t necessarily vote that way. He backed scrapping the entire statute back in 2012 and made clear at that time that he detested the law.
Oral arguments are interesting and important – but rarely decisive. If you think you know how the court will rule – well you have a 50-50 chance of being right.
A few things did come out that health journalists should note. Continue reading
With oral arguments in King v. Burwell scheduled for tomorrow, the Supreme Court will likely rule in late June.
The case challenges whether subsidies, in the form of tax credits, can go to people in states using the federal exchange, or only to those in the states running their own health insurance marketplaces.
After the state cases and 2012 National Federation of Independent Business case, it is the third case that poses an existential threat to the Affordable Care Act. (Hobby Lobby and other contraception-related cases wouldn’t unspool the structure of the whole ACA, only that aspect of women’s preventive health care.)
This case isn’t about whether the Affordable Care Act is constitutional. (The 2012 case was.) This is about interpreting the text, and whether the language of the law allows the subsidies in the federal exchange states.
Learn more about the landmark Supreme Court case in this new tip sheet.