Opponents of the healthcare reform law tried this year to kill it with a thousand legal cuts, and one of those attacks in particular may yet prove disabling.
In November, the U.S. Supreme Court unexpectedly agreed to hear King v. Burwell, which considers whether the language of the Patient Protection and Affordable Care Act allows Americans in states that have not “established” their own insurance exchanges to receive federal premium tax credits. The Obamacare opponents who filed the challenge cite one part of the law that says the tax credits are available to Americans who enrolled “through an exchange established by the state,” which they say means that people in the 34 to 37 states using the federal exchange aren't eligible to receive them. The Obama administration counters that the law read in its entirety authorizes the subsidies in every state.
If the high court invalidates the subsidies, millions of Americans are likely to drop their coverage because it would no longer be affordable. Experts say that would disrupt the law's coverage expansion and insurance reforms, drive up premiums and create strong political pressure to roll back or repeal the entire law.
Tim Jost, a law professor at Washington and Lee University who supports the reform law, said that when Republicans failed in their 2012 constitutional challenge to the law before the Supreme Court, lost the presidential election that year and failed to repeal it after dozens of votes in the House, “they decided their best shot was to file lots of lawsuits.” He is very worried about the King case, which may hinge on the vote of Chief Justice John Roberts, who was sharply criticized by conservatives for upholding the law in 2012.
