US courts put Oba­macare in doubt

Viet Nam News - - Insight -

By David Mor­gan and Aruna Viswanatha WASH­ING­TON — Two US ju­di­cial panels have in­jected new un­cer­tainty into the fu­ture of Pres­i­dent Barack Obama’s 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 pres­i­dent’s 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 Obama’s sig­na­ture do­mes­tic pol­icy.

The cases deal with the govern­ment’s 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 panel’s 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 court’s con­ser­va­tive ma­jor­ity ruled again on the law, say­ing closely held for-profit cor­po­ra­tions could ob­ject to Oba­macare’s con­tra­cep­tion pro­vi­sion on re­li­gious grounds.

“To­day’srulingisal­so­fur­ther proof that Pres­i­dent Obama’s 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 Amer­ica’s 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 won’t, 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 Congress’s in­tent.”

The DC panel’s dis­sent­ing judge Harry Ed­wards, ap­pointed by Demo­cratic pres­i­dent Jimmy Carter, wrote the ma­jor­ity’s 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.” —

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