The U.S. Supreme Court's 6-3 decision upholding premium subsidies for Americans in all states puts to rest months of fretting over the immediate future of the Affordable Care Act. While it doesn't necessarily drive a stake through the heart of all anti-Obamacare litigation, legal experts agreed it does send a discouraging message to the law's legal foes.
Last week's decision in King v. Burwell should be a “big hint” to ACA challengers that the Supreme Court is not going to tolerate attempts to use the courts to change the law, said Elizabeth Wydra, chief counsel for the liberal Constitutional Accountability Center. The strength of the majority opinion should be a signal to ACA opponents that they need to work through the political process, she said.
Even some opponents of the law expressed pessimism about rolling it back through the courts.
“We're kind of on the downward spiral,” said Hans von Spakovsky, a senior legal fellow at the conservative Heritage Foundation. Any big changes in the law, likely will have to wait until voters elect a Republican president, he added.
Still, the King ruling isn't the end of the line for Obamacare foes seeking to hobble the ACA through the courts.
The high court majority, led by Chief Justice John Roberts, held that the law read in its entirety was clear in allowing Americans in all states to receive the subsidies. The majority rejected the plaintiffs' narrow focus on a section of the law stating that subsidies are available only to those who enroll through “an exchange established by the state.”
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the opinion. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”
The justices declined to find the law's wording ambiguous as grounds for upholding the subsidies under the court's Chevron doctrine of deferring to administrative discretion when a statute is unclear. Such reasoning would have left the matter of subsidies open to re-interpretation by future presidential administrations.
If the court had ruled against the Obama administration, an estimated 6.4 million Americans in at least 34 states would have lost their subsidies, making coverage unaffordable for many of them and throwing the entire individual insurance market into turmoil.
A dissenting opinion written by Justice Antonin Scalia and joined by Justices Samuel Alito and Clarence Thomas criticized the majority for performing “somersaults of statutory interpretation.” Scalia wrote that the phrase “established by the state” is clear and should disallow subsidies through the federal exchange.
“Words no longer have meaning if an exchange that is not established by a state is 'established by the state,' ” he wrote.