USA TODAY International Edition
Obamacare ruling leaves both parties relieved
For a law that has been under ceaseless attack since Congress began debating it in 2009, Obamacare has proved to be remarkably durable. On Thursday, the Supreme Court dismissed the latest mortal challenge to the health law on a 6- 3 decision, practically a landslide in a court that often divides 5- 4 on major rulings.
Opponents had pinned their hopes for remaking Obamacare on this case; now they’ll have to live with the law unless a Republican president and Congress can find a way to dismantle it after the 2016 elections. That gets harder every year, as millions more people obtain health insurance they would not have had. For all its flaws, Obamacare has been gratifyingly successful at broadening coverage, and the court correctly saw through a flimsy challenge.
Despite the loss and their bitter complaints about it, Republicans might be secretly as pleased as President Obama was at the decision, which he said meant the law was “here to stay.” Had the court ruled for the challengers, more than 6 million people stood to lose the federal subsidies that make their health insurance affordable.
Republicans then would have been under enormous pressure to figure out how to let people keep their policies. But the party is deeply divided over how to redo the law along conservative lines, and now it doesn’t have to. Instead, critics are free to continue to snipe, with no responsibility for doing the hard work it would take to write a Republican alternative and build a majority for it. You could almost hear the sigh of relief from Capitol Hill.
This latest challenge was always a feeble, “gotcha” sort of a case, and the court majority saw it that way, ruling that despite some “inartful” wording, the law’s clear intent would have been undermined had the court sided with the challengers.
Those attacking the law built their case on six words deep in the statute that seemed to restrict insurance subsidies only to people who bought their policies on “an exchange established by the state.” Because 34 states have been unwilling or unable to create exchanges, the government had to step in with a federal exchange; the challengers argued that the law plainly prevented people in that government marketplace from getting subsidies.
In his majority opinion, Chief Justice John Roberts said the law’s obvious goal was to strengthen insurance markets; if subsidies were restricted only to state exchanges, markets in most states would fall into a “death spiral” as people dropped out and premiums soared.
“Congress passed ( Obamacare) to improve health insurance markets, not to destroy them,” Roberts said. “If at all possible, we must interpret ( the law) in a way that is consistent with the former, and avoids the latter.”
The ruling galled Justice Antonin Scalia, who noted in a scathing dissent that this was the second time the Roberts court had saved the Affordable Care Act. “We should start calling this law SCOTUScare,” Scalia mocked, substituting the abbreviation for Supreme Court of the United States.
Now that the law has survived its latest near- death experience, it’s time to turn to fixing its flaws, expanding Medicaid in the states that haven’t done so, and addressing problems such as hospital overcharges that continue to afflict American health care.