Engage with…the ACA at the Supreme Court

By Brad O’Neil

As many as 8.2 million people in 34 states, including Michigan, could have their health insurance coverage taken away if the Supreme Court rules to cancel federal tax credits that have helped people buy insurance. Yes, you read that correctly – they could lose the coverage they just gained.

Thanks to the Patient Protection and Affordable Care Act (ACA) and its success in making health insurance coverage more affordable and comprehensive, the uninsured rate has dropped from 17.3 percent to 13.8 percent in 2014 alone. Since the law went into effect, the total number of uninsured Americans has dropped by nearly 30 percent from 42 million to 28.9 million — that’s over 13 million people who now have access to health care because of the ACA.

But there are those who are working to halt this progress and it all rests on how the Supreme Court rules in the case of King v. Burwell. The case, which comes after the Supreme Court upheld the constitutionality of the ACA in 2012, challenges the government’s legal authority to provide tax credits to customers on the federal health insurance exchange.

The ACA says that individuals who enroll in plans through state health insurance exchanges are eligible for federal tax credits to help pay for that coverage. What it doesn’t mention, however, is the federal health insurance exchange, healthcare.gov, which became necessary to establish when many states refused to set up their own exchanges due to their opposition to the law or, in a few cases, lack of technical ability.

The credits were designed to help middle and low-income individuals pay for health insurance coverage. In fact, 86 percent of Michiganders who purchased policies on the federal exchange received tax credits.

Because of the absence of specific language regarding federal exchanges, the plaintiffs argue that providing tax credits to those who shop on the federal health insurance exchange is illegal. The Obama administration contends that the law has always intended to help those in all states and that many other aspects of it support that intent. In addition, there is plenty of precedent in court rulings that support the notion that when there is a lack of clarity in law, it’s up to regulators to interpret it – not courts.

Unfortunately, this isn’t the only lawsuit targeting the ACA. Halbig v. Sebelius, a federal case filed in Washington D.C., which counts Attorney General Bill Schuette as one of its signatories, also targets the legality of federal tax credits. The case has already been rejected once but was appealed and oral arguments will be heard next month. This is just one of nine lawsuits Schuette has been involved in regarding the ACA. He has previously filed Amicus briefs in seven other cases and been a party in one other lawsuit.

For a program that seems to be doing exactly what it was intended to do – insuring as many people as possible – while not wreaking havoc as its opponents claimed it would, one has to wonder where the motivation for all this legal action is rooted. Whatever the reason, we’d all be better served if it were to end, because the longer it continues the longer newly insured Americans remain vulnerable.