Saturday, June 27, 2015

Obamacare Subsidies Decision: Recap

(Friday's marriage decision...Must be honest: Alleluia!
We'll recap that in the next post.
Well, a later post.)

We previewed the Obamacare subsidies case a couple of weeks ago:
Supreme Blockbusters Coming: Marriage, Obamacare, Execution, & Confederate Flag (Part 2--Obamacare)
[BTW, called it! Both the outcome and the voting line-up. Of course, if you make predictions, every once in a while you'll get one right.]

Here's a recap of the specifics of the decision in King v. Burwell:

  • Tax subsidies are available for purchases of health insurance on the federally established markets ("exchanges"), as well as on those established by the states.
  • The vote was 6 to 3.
  • Majority: Chief Justice Roberts, joined by Justices Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan [I.e., Roberts & Kennedy + the 4 liberals]
  • Dissent: Justice Scalia, joined by Thomas and Alito [I.e., the 3 most conservative Justices]
  •  [The decision basically saves the health insurance scheme under the Affordable Care Act (ACA "Obamacare"). Most insurance purchases under the law have been made through the federal exchanges because most states--under Republican control--have refused to set up their own state exchanges.]
Chief Justice Roberts' Opinion for the Court/Majority
  • The Massachusetts health insurance plan has succeeded in drastically expanding access to health care coverage [Roberts seems very positive about the Massachusetts plan, aka "Romneycare"]
  • The federal plan was modeled after that one
  • Essential to both plans is assistance to make insurance affordable to lower income purchasers
  • Under the ACA, the federal plan, states are authorized to establish exchanges, and the federal government is required to do so in states that don't
  • The "inartfully" drafted ACA provides that tax subsidies are available when insurance is purchased on "an Exchange established by the State"
  • Considering the entire law and its purpose, that provision must include what the law refers to as a federally established "such Exchange within the State" 
  • Otherwise, because the law restricts insurance purchases to an individual who "resides in the State that established the Exchange," purchases would not even be allowed on federally established exchanges and they would, thereby, serve no purpose whatsoever
  • Further, the unavailability of subsidies on federal exchanges would create "death spirals" in the health insurance markets that both the Massachusetts and federal plans were intended to avoid; the result would be "calamitous"

Justice Scalia's Opinion for the Dissenters

  • It is "quite absurd" to say that "Exchange established by the State" means "Exchange established by the State or the Federal Government"
  • We must presume that lawmakers mean the "natural and ordinary signification" of the words they use
  • The Court's majority has engaged in "somersaults of statutory interpretation" that will add confusion to "honest jurisprudence"
  • The majority's principle: "The Affordable Care Act must be saved"
  • The law should now be called "SCOTUScare"

To recap the recap:
1) Federal and state exchanges are to be treated equally--specifically for the availability of  tax subsidies for lower income purchasers of health insurance.
2) Roberts for the majority: "an exchange established by the state" should be interpreted in coordination with the entire law and its overriding purpose--hence, that phrase should be read to include a federal exchange established in a state that failed to set one up itself.
3) Scalia for the dissenters: the phrase means only what it says--no more, no less.

In the next--ummm, a later--post we'll recap the same-sex marriage decision.