King v Burwell (ACA Subsidies) Decision Announced

[MichaelB]

The US Supreme Court today released its decision on King v Burwell. In effect, it concurs with the view that the federally run marketplace exchanges may provide subsidies to eligible consumers. In other words, the exchanges and insurers can continue to operate as they do now, and consumers can continue using the exchanges to get their healthcare policies in the upcoming open enrollment period.

Details on the ruling can be found at SCOTUSblog SCOTUSblog

 

[rbmrtn]

Subsidies affirmed

Opinion just released. Decision of the Fourth Circuit is affirmed in King v. Burwell. 6-3.

 

[rbmrtn]

Here's a link to the opinion, http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf

 

[ERD50]

I saw the title, thought maybe it was a boxing match decision? I don't follow sports, and didn't know this issue by name.

So what does this mean to someone in a state on their own exchange, and someone on a state on the fed exchange?

-ERD50

 

[brewer12345]

I saw the title, thought maybe it was a boxing match decision? I don't follow sports, and didn't know this issue by name.

So what does this mean to someone in a state on their own exchange, and someone on a state on the fed exchange?

-ERD50

It means you can go back to sleep. Nothing will be changing.

 

[rbmrtn]

You can keep your subsidy on the Federal exchange, if you get one. They used a line of thought that I had previously mentioned as an argument.

If a State chooses not to follow the directive
in Section 18031 to establish an Exchange, the Act tells the
Secretary of Health and Human Services to establish “such Exchange.”
§18041. And by using the words “such Exchange,” the Act
indicates that State and Federal Exchanges should be the same

 

[audreyh1]

Whew!

Not that I was using the subsidy, but still....

 

[easysurfer]

Whew!

Not that I was using the subsidy, but still....

I think the decision is a win-win-win for both sides and no chaos come re-enrollment time.

I saw the title, thought maybe it was a boxing match decision? ...

-ERD50

Probably more action then that Manny Pacquiao vs Mayweather fight

 

[audreyh1]

I think the decision is a win-win-win for both sides and no chaos come re-enrollment time.

Probably more action then that manny pacquiao vs mayweather fight

Exactly - there was going to be major disruption otherwise.

There may be some early retiree wannabes who waited for this decision.

 

[MichaelB]

Here's a link to the opinion, http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf

Thanks for the link.

 

[aaronc879]

 

[NW-Bound]

The SCOTUS opinion acknowledges that ACA "contains more than a few examples of inartful drafting", but rules that the intention was for all exchanges to be available for subsidy, based on the context of the act, if not its wording.

The dissenting view holds that it is not SCOTUS job

"to judge the quality of the care and deliberation that went into this or any other law. A law enacted by voice vote with no deliberation whatever is fully as binding upon us as one enacted after years of study, months of committee hearings, and weeks of debate. Much less is it our place to make everything come out right when Congress does not do its job properly. It is up to Congress to design its laws with care, and it is up to the people to hold them to account if they fail to carry out that responsibility."​

And we are still waiting for Congress to fix the various "cliffs" in the subsidy formulas.

 

[brewer12345]

Yee-haw! We are not on subsidy this year due to having a high income (for now), but we do have an exchange policy. I really did not want to see a more reasonable health insurance marketplace being destroyed by an arbitrary court ruling.


Of course now we will see the President do his Church Lady "Superiority Dance" and the other side will foam at the mouth in front of the cameras to drum up campaign funds while secretly breathing a sigh of relief that they do not have to fix a mess.

 

[travelover]

It seems to be that whoever wrote the thing screwed up on the wording. The Supreme Court didn't want to throw the whole ACA into a death spiral by overturning it based on the part about no subsidies on state exchanges, which I understand completely, but if they followed the letter of the law, and not the intent of the law, its pretty clear that it should've been overturned. Not sure how I feel about that. Is the Supreme Court supposed to rule on the law or the intent?

I'm no lawyer, but my understanding is that this is a common issue in complex documents. You have to take a single phrase in context to the intent of the entire document.

 

[MichaelB]

Two threads on the same topic so they were merged. Let's stay away from the politics - please.

 

[utrecht]

I'm no lawyer, but my understanding is that this is a common issue in complex documents. You have to take a single phrase in context to the intent of the entire document.

Probably so, but you would think these law makers would make sure these monumentally important laws would be written better.

PS..my earlier post mentions "no subsidies on State exchanges". I meant it the other way around.

 

[Calico]

On a personal level, I'm relieved. I live in a state with a federally-run exchange, and while I still w#rk and have insurance through my employer, as I approach 60 it's a huge relief to know I could afford to purchase HI IF anything happened to my j#b.

On a larger level, I'm relieved folks currently purchasing insurance on the exchanges will continue to be able to afford it.

 

[unclemick]

I hate when I get too old for stuff. At age 72(now 22 yrs ER) I miss the the good old rant and rave against the gods and others when I went 12 years without health insurance early in ER.

heh heh heh - But football season is around the corner.

 

[Telly]

I'm glad to hear it resolved this way. We are on a group plan through DW's employer, and the new increase of it will move it up to $7,500 a year for a high deductible plan covering the two of us. But the ACA is, and now remains, a safe backup plan if something hits the fan before Medicare age. Doesn't lock DW into working for insurance.

In the early 2000s I and the (then) kids went on a private ins. plan, premiums escalated every 6 mos. after a bit, never filed a claim, and we were in excellent health and health record.
But run forward over ten+ years, and DW and I no longer have that nice no-issues-ever record. The ACA no denial on any pre-existing condition clause is a giant help (not that I personally HAVE any ongoing "condition", but underwriters like to deny/exempt about anything they can, no matter how trivial, speaking from my experience with private insurance).

 

[travelover]

Probably so, but you would think these law makers would make sure these monumentally important laws would be written better..............

Two hundred years later, we are still arguing about what the heck a "well regulated militia" is.....

 

[NW-Bound]

Loose wording besides, I could not believe they had these "cliffs" in the subsidy schedules. When it comes to numbers, income brackets, and charts, it should be clear as black and white what they represent. I do not believe these booboos were intentional, do you? They had to be a terrible oversight.

The above said, had the SCOTUS ruled the other way on this decision, that would make it a bigger mess.

 

[Theseus]

I was waiting with a good bit of trepidation for this ruling, and did breathe quite a sigh of relief this morning when reading the live results on SCOTUS blog. Yes, DW and I are on subsidy plans, and that does help out with our ER finances. But as a cancer survivor, I faced the very real possibility of returning to denial of insurance for pre-existing conditions in the case of insurance industry upheaval that could have eventually resulted had the decision gone the other way.

Forgoing the subsidy--and I really look at that as no different than reducing taxes by Roth conversions--if it alone were unavailable is one thing, and that could have been coped with in some fashion. But the specter of being unable to obtain insurance at any price was something I hope to never encounter again. Not having that sword hanging over my head any longer is priceless to me.

 

[ziggy29]

I was waiting with a good bit of trepidation for this ruling, and did breathe quite a sigh of relief this morning when reading the live results on SCOTUS blog. Yes, DW and I are on subsidy plans, and that does help out with our ER finances. But as a cancer survivor, I faced the very real possibility of returning to denial of insurance for pre-existing conditions in the case of insurance industry upheaval that could have eventually resulted had the decision gone the other way.

This decision had nothing to do with pre-existing condition exclusions or medical underwriting per se; just whether or not the subsidies could be received in states that use the federal marketplaces.

Though the reality could have been that markets would be distorted in the states with no subsidy, it would be a lot cheaper to eat the penalty, and you might start seeing adverse selection creep into the markets creating significantly higher premium costs.

 

[Mo Money]

The ACA was the keystone to my ER. Without it, with a pre-existing condition and being in my early (now mid) 50s, I would have had real difficulty finding health insurance at all, let alone affordable health insurance.

Ahhhhh. (That's a sigh of relief, not a prelude to a cussword!)

 

[shotgunner]

Loose wording besides, I could not believe they had these "cliffs" in the subsidy schedules. When it comes to numbers, income brackets, and charts, it should be clear as black and white what they represent. I do not believe these booboos were intentional, do you? They had to be a terrible oversight.

I believe Jonathon Gruber, a prime architect of the ACA was caught on video claiming the wording was no accident. It was a threat/incentive to motivate the states to create individual exchanges and participate in this part of the ACA. The Federal Exchange came about when a majority of states declined/failed to do so.

I happy with today's ruling, makes my life and ER going forward to age 65 much easier.