BY MARK ROSENBERG, M.D.
For those who were on vacation on a South Pacific island in June, the U.S. Supreme Court, in King v. Burwell, upheld the administration’s reading of the Affordable Care Act (ACA or Obamacare), thus preserving a key provision of this landmark legislation. The challenge rested on the interpretation of the phrase “an Exchange established by the State.” If, as plaintiffs claimed, this phrase referred exclusively to health insurance exchanges run wholly by a state government and not by the federal government, residents of states using the federal exchange would be deemed ineligible for the advance premium tax credits that make health insurance affordable under the Affordable Care Act. Illinois has been using the federal exchange.
The Court, by a 6-3 margin, concluded that such a cramped reading was inconsistent with the law that Congress passed in 2010. In the majority opinion, the justices affirmed that a primary intent of the law was to subsidize the purchase of health insurance. To read the subject phrase in isolation as plaintiffs argued it should be read would defeat that core purpose of Obamacare by depriving millions of low-income Americans of affordable health insurance simply because the state they resided in chose not to create its own insurance exchange. Justice Antonin Scalia, who called this reasoning “pure applesauce,” wrote a vitriolic dissent.
Unfortunately, the SCOTUS decision in King v. Burwell will not end challenges to the Affordable Care Act. Republicans in Congress, including 10th District Congressman Bob Dold, will continue to waste their time and our money by voting to repeal or gut Obamacare, and the Republican-controlled states that have refused to expand their Medicaid programs (see accompanying article) will continue to deny their lowest income residents access to affordable healthcare.
Perhaps after the 2016 election, Congressional Republicans will stop grandstanding and abandon efforts to repeal the Affordable Care Act. Then Congress may be ready to work to improve Obamacare and Medicare to ensure that all Americans have access to quality, affordable healthcare.