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Friday, Feb 27 2015

Full Issue

King v Burwell Views: GOP Unity Needed; Watching Roberts Again; Insurers' Risk

Many outlets offer opinions on the upcoming Supreme Court arguments over a key provision in the health law.

Pure, unadulterated political gifts don鈥檛 come often to Washington, and even when they do their recipients are often too busy inspecting the horse鈥檚 mouth to make use of them. The miracle gift this season is King v. Burwell, and next week will show whether Republicans have the wit to unify around an effective strategy to dismantle ObamaCare. (Kimberley A. Strassel, 2/26)

Next week, the Supreme Court will hear a case that threatens to ax the subsidies millions of Americans receive for health insurance purchased on Obamacare鈥檚 federally run exchanges. And a sizable chunk of the population seems to be cheering for exactly that result. First, though, perhaps we should all look in the mirror and consider how much in health subsidies we鈥檙e milking from the government ourselves. (Catherine Rampell, 2/26)

Once again, the future of the Affordable Care Act is in the Supreme Court鈥檚 hands. In King v. Burwell , which will be argued before the court Wednesday, opponents of Obamacare are claiming that under the law, subsidies for health insurance should be available only to people buying coverage on exchanges 鈥渆stablished by the state,鈥 i.e. state-run marketplaces. But 34 states don鈥檛 have their own exchanges, so their residents rely on the federally run marketplace. If the court rules in favor of King, the tax credits would end in those states. Let鈥檚 separate fact from fiction about this legal battle stemming from a mere four words. (Elizabeth B. Wydram 2/26)

If the plaintiffs prevail, millions of people in 34 states who bought insurance on federal exchanges would suddenly lose the subsidies that make it affordable. ... Entire segments of the health system redesigned their business models to take advantage of the ACA鈥檚 incentives. ... If subsidies vanish, [Stuart Butler says,] 鈥渟uddenly the market is misaligned. If you鈥檝e hired all these new doctors and health-care workers to cover all these new people walking in the door, and they don鈥檛 come, what do you do? You lay them off.鈥 (Joshua Green, 2/26)

The potential impact of a Supreme Court decision gutting Obamacare subsidies in three dozen states is often discussed in terms of the millions who could lose health coverage, potentially destabilizing insurance markets across the country. But it turns out that the impact could be considerably more dramatic than that, radiating out to produce untold economic damage, too. (Greg Sargent, 2/26)

When the Supreme Court hears oral arguments in King vs. Burwell next week, all eyes will be on Chief Justice John G. Roberts Jr., to try to figure out which way he's leaning. After all, this case is the latest challenge to the Affordable Care Act, and the last time the law was before the high court, Roberts was the deciding vote in favor of the government. There's one very good reason to think the chief justice will rule for the government again: He's too good a lawyer to do otherwise. (Brianne J. Gorod, 2/26)

The problem for insurers is that they have already set their rates for 2015 -- and by the time the Supreme Court issues its ruling, many will also have submitted rates for 2016. If their insurance mix suddenly changes for the worse, they stand to lose a lot of money. So the American Academy of Actuaries has sent a letter to the administration, asking that insurance companies be allowed to resubmit more appropriate rates in the event of an adverse ruling. Obviously actuaries, who tend to work for insurers, are not exactly neutral parties on this question. Nonetheless, they're right: Insurers should be allowed to submit new rates if the government loses in King. (Megan McArdle, 2/26)

This spring will mark the 800th anniversary of the signing of the Magna Carta, the landmark agreement by King John of England at Runnymede ceding certain rights to rebel barons. Liberty will have another chance to shine on Wednesday when the Supreme Court hears a case with momentous implications about another sort of executive power. In this instance, though, it is the rebels who have the royal name: King v. Burwell raises questions about how President Obama has enforced the ObamaCare law鈥攐r, more precisely, modified, delayed and suspended it. (Ilya Shapiro and Josh Blackman, 2/26)

The challengers maintain that the case is simply about reading plain language. (I have detailed elsewhere why their hyper-literal reading of four words out of context is anything but plain and is not how the Supreme Court usually reads statutes.) But King is about a lot more than this. The case is about federalism鈥攖he role of states in our national democracy. The reason the challengers don鈥檛 want anyone to realize that is because the very text-oriented justices to whom they are appealing are the exact same justices who have consistently interpreted federal laws to protect states鈥 rights. And the challengers would read the ACA in the opposite way鈥攁s having devastating implications for the states. (Abbe R. Gluck, 2/27)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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