US courts put Obamacare in doubt
By David Morgan and Aruna Viswanatha WASHINGTON Two US judicial panels have injected new uncertainty into the future of President Barack Obamas healthcare law, with conflicting rulings over whether the federal government can subsidise health insurance for millions of Americans.
The appeals court rulings, last week handed down by three-judge panels in Washington, DC, and Richmond, Virginia, augured a possible rematch before the US Supreme Court, which in June 2012 narrowly upheld the Democratic presidents 2010 healthcare overhaul.
The twin rulings fell in line with partisan disagreementsoverhealthcarereform, with two judges appointed by Republican presidents deciding against the administration intheDistrictofColumbiaand three judges appointed by Democrats ruling in favour in Virginia.
The rulings also reignited the debate over Obamacare on Capitol Hill and on the campaign trail to November congressional elections. Republican opponents of the law welcomed the DC decision as a further step toward dismantling Obamas signature domestic policy.
The cases deal with the governments ability to offer premium tax credits to people who purchase private coverage through the federal insurance marketplace that serves the majority of the 8 million consumers who signed up for 2014.
The US Court of Appeals for the District of Columbia Circuit ruled in a 2-1 decision that the language in the Affordable Care Act dealing with subsidies shows they should only be provided to consumers who purchase benefits on exchanges run by individual states.
Most states including FloridaandTexas, whichhave some of the largest uninsured populations, opted to leave the task of operating a marketplace to the federal government.
But plaintiffs in the DC Circuit case, known as Halbig v. Burwell, claimed that Congress did not intend to provide subsidies through federally operated marketplaces.
The plaintiffs were identified as a group of individuals and employers from states thatdidnotestablishtheirown marketplaces. likely to overturn its panels ruling or at least revisit it.
The Supreme Court upheld the Obamacare law on constitutional grounds in 2012 but allowed states to opt out of a major provision involving Medicaid coverage.
Last month, the high courts conservative majority ruled again on the law, saying closely held for-profit corporations could object to Obamacares contraception provision on religious grounds.
Todaysrulingisalsofurther proof that President Obamas healthcare law is completely unworkable. It cannot be fixed, House Speaker John Boehner said in a statement.
Obamacare advocates welcomed the Virginia ruling, which House Democratic leader Nancy Pelosi said affirms the intent of the Affordable Care Act: to make quality, affordable health insurance available to every American in every state.
Outside the political sphere, stock market reaction to the rulings was muted for health insurers like WellPoint Inc and Aetna Inc, which sell plansonmanyObamacareexchanges.
Industry officials predicted that a final decision would take months or longer to sort out, with no immediate impact expected on their business. In the meantime, health plans remain focused on ensuring stability, affordability and accessibility for consumers, said Brendan Buck, spokesman for Americas Health Insurance Plans, a main lobbying and trade group.
Analysts estimate that as many as five million people could be affected if subsidies disappear from the federal marketplace, which serves 36 states through the website HealthCare.gov. Subsidies are available to people with annual incomes of up to 400 per cent of the federal poverty level, or US$94,200 for a family of four.
This has got probably more rounds of appeals and so forth, so nothing is going to really happen right now, said John Holahan of the nonpartisan Urban Institute.
Some states may jump into action to set up their own exchanges to qualify as statebased exchanges, Holahan added.
Others wont, in which casetherewillbealargenumber of uninsured that will remain and possibly grow.
The two-judge majority in the DC Circuit case, judges Thomas Griffith and Arthur Randolph, wrote: The fact is that the legislative record provides little indication one way or the other of congressional intent, but the statutory text does.
(It) plainly makes subsidies available only on exchanges established by states.
And in the absence of any contrary indications, that text is conclusive evidence of Congresss intent.
The DC panels dissenting judge Harry Edwards, appointed by Democratic president Jimmy Carter, wrote the majoritys judgement defied the will of Congress and ignored the authority Congress vested in agencies to interpret and enforce the healthcare law.
The Virginia appeals court, while siding with the administration, waslukewarm in its support, saying: The court is of the opinion that the defendants have the stronger position, although only slightly.