In King versus Burwell, Chief Justice John
Roberts joined Anthony Kennedy and the court’s four more liberal members in
upholding health insurance subsidies for people on federal exchanges.
Plaintiffs had argued that the law meant only to provide subsidies for people
on state exchanges. The controversy surrounds the language in the law stating
that subsidies would be provided for “exchanges established by the State”. In
ruling that the law does not preclude subsidies for people on federal
exchanges, Roberts observed that withholding subsidies for such people would
drastically reduce the number of insured people and seriously harm the
insurance market. How could Congress have intended that, when the very purpose
of the law was to expand access to insurance while reducing the cost?
Also, language elsewhere in the law suggests that
Congress meant to include people on federal exchanges—for example, the law
provides a means for people on federal exchanges to calculate their subsidy.
Justice Scalia said that was not a problem; their subsidy would be calculated
as zero. That seems a strange means of notifying people that they are
ineligible for subsidies; it would seem simpler (if more blunt) to tell
them “No, your state doesn’t give a crap about you, so neither do we.” Yet
Justice Roberts recognized that viewed as a whole, the law includes everybody,
which seems consistent with the stated intent of legislators and the president.
To be sure, the law is poorly written. Its
opponents took advantage of that fact to argue that Congress purposefully wrote
a law that in practice would undermine its expressed intentions. Nor does it
seem likely that Congress failed to recognize the fatal problems that denying
federal subsidies would create, as these problems were well-known and widely
discussed; indeed they were part of the motivation for writing the law—to
address problems of adverse selection and death spirals.
Perhaps still, the majority made a mistake.
Perhaps they should have said that yes, the language of the law restricts
subsidies to state exchanges, whether that was what legislators had in mind or
they just made an error; but in any case, Congress needs to go back and rewrite
the law if they really wish to do what they repeatedly and forcefully said they
meant to do when they passed it. Criticizing the ruling, Peter
Suderman insists that we cannot trust Obama to interpret
Obamacare; maybe this is correct legal analysis even if it is not common sense.
Of course, the real motivation of this lawsuit was
to eliminate Obamacare. Had the Court sided with the plaintiffs, that might
well have happened, as the law only works if virtually everyone is covered,
which cannot happen if low-income people do not receive help. And yes, as the
law’s opponents have said, there are alternative ways to expand coverage, but they
did not implement them in the eight years a sympathetic president was in office
before Obama, nor do their smaller plans provide anything like the
near-universal and comprehensive coverage that Obamacare offers. So even as I
encourage Congress to write more competently, I do not hold the legislators’
failure against millions of vulnerable Americans—and I am glad that Justice
Roberts did not, either.
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