Science Blog: King v. Burwell: Supreme Court case could wreak havoc on working families, state governments and health providers

Science Blog: King v. Burwell: Supreme Court case could wreak havoc on working families, state governments and health providers

By Kim Krisberg

“Established by the state.” Those are the four words at the center of an upcoming Supreme Court case that could strip affordable health insurance coverage from millions of working families and result in billions of dollars in uncompensated care costs.


Jane Perkins, legal director for the National Health Law Program, told me that the plaintiffs have to prove that the “statute is unambiguous on its face” and as a result, the IRS regulations about federal subsidies are beyond the agency’s authority. However, Perkins said that a hallmark of statutory construction is to determine the meaning of words by looking at the statute as a whole — in other words, you don’t untether a small group of words from its statutory context.

“The intent and wording throughout (the ACA) is to extend coverage to as many Americans as possible and the whole statute is set up to do just that,” Perkins said. “I think if the court ruled for the plaintiffs, it would not only upset (the entire) ACA, it would be reworking the rule of statutory constructions that has applied in cases for generations.”

Regarding the ruling’s potential impact, Perkins said “it would be a sucker-punch to the gut of the middle class if this ruling came down in favor of these politically driven plaintiffs.” She noted that the great majority of those affected if subsidies go away would be working people. However, she also said that if the Supreme Court rules in the plaintiffs’ favor, Congress could still step in to fix the law’s language or help states convert as seamlessly as possible to state-operated insurance exchanges.

“But it would be a very bumpy road,” Perkins said. Read the full article here. »

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