The health coverage of millions of Americans in 34 states was pending upon the Supreme Court decision on the King v Burwell case. Luckily, common sense prevailed and the Supreme Court based its ruling on the original motivation behind the creation of the exchanges rather than on the plain language used in the provision.
King v. Burwell was one of the lawsuits that challenged the tax subsidies received by individuals purchasing health coverage through federally-run exchanges in the 34 states that have not implemented their own exchanges. Because the Internal Revenue Code section 36B explicitly states that subsidies would be provided for “qualified health plans offered in the individual market (…) and which were enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act or (...),” the plaintiffs argued that those who purchase insurance through federally-run exchanges would not qualify for the tax subsidies. Coordinated by the Competitive Enterprise Institute, this lawsuit was originally filed on behalf of Virginia residents. Although in July 2014 the US Court of Appeals for the Fourth Circuit ruled unanimously for the government, the US Supreme Court announced in November 2014 that it would hear the case. With a 6-3 majority, the Supreme Court ruled in favor of the administration last Thursday. Claiming that “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them” and that “subsidies are necessary for the federal exchanges to function like their state exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid,” the Supreme Court gave its much-deserved consideration to the rationale behind the creation of exchanges rather than to the mere language used in the provision.
As a result of this ruling, individuals and families purchasing qualified health plans through the federally-run exchange will continue to receive their premium subsidies and cost-sharing reductions. This Supreme Court decision is good news because for millions of Americans, a ruling in favor of the plaintiffs would have had the following consequences:
The Supreme Court ruling, therefore, is nothing but good news for those 4.6 to 9 million Americans in 34 states that will continue to receive subsidies to purchase health insurance plans through the federally-facilitated exchange. Even if I still can´t come to terms with such a weak argument making it to the Supreme Court (in a country with over 300 million people, I expected the Supreme Court to have more important things to do than hear such a puerile argument), it is good to know that common sense finally prevailed.