Modern Healthcare

House GOP ACA lawsuit heats up in appeals court

- —Erica Teichert

The Obama administra­tion on Monday will fire its first missive in federal appeals court defending the appropriat­ions used to fund portions of the Affordable Care Act.

A federal judge sided with House Republican­s in May, ruling that the administra­tion illegally funneled money to support the ACA’s cost-sharing subsidies, which can be used to cover out-of-pocket costs, even though Congress never appropriat­ed the funds.

Over the summer, the federal government appealed the decision to the U.S. Court of Appeals for the District of Columbia Circuit. Experts say there will be a fierce battle over the controvers­ial provisions that may ultimately end up in the U.S. Supreme Court.

In the lower court proceeding­s, the administra­tion alleged the provisions were linked to congressio­nally approved tax credits, a move U.S. District Judge Rosemary Collyer called “most curious and convoluted.”

It is likely the administra­tion will ask the D.C. Circuit to determine if House Republican­s even had standing to bring the lawsuit. The U.S. Supreme Court in 2015 upheld premium subsidies in King v. Burwell.

According to the CMS, approximat­ely 56% of Americans receiving insurance coverage via the ACA exchanges received cost-sharing reductions as of June 2015.

Collyer’s decision won’t go into effect until the D.C. Circuit rules on the appeal. It’s unclear how much the ruling could damage the law if it’s upheld by the D.C. Circuit or Supreme Court, but legal experts say it’s unlikely it would doom the law as a whole.

Oral arguments have not been scheduled, and the parties will develop the case in briefs through early December.

 ??  ?? Obama’s signature legislativ­e success faces a legal test.
Obama’s signature legislativ­e success faces a legal test.

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