In anticipation of a decision on the King v. Burwell case re: the Affordable Care Act’s (ACA) Tax Credit Provision, Northeast Delta Dental had completed scenario planning and I had speculated on the outcome in two earlier blogs. Well, on Thursday, the Supreme Court of the United States (SCOTUS), released its decision on the applicability of the ACA’s tax credit provisions to people purchasing plans on the Federally Facilitated Marketplace and decided that yes, they do. The government won. The vote was 6-3 with Roberts, Kennedy, Ginsburg, Breyer, Sotomayor and Kagan voting in the affirmative (Roberts delivered the decision); Scalia wrote the dissenting opinion in which Thomas and Alito joined. This means life goes on for Northeast Delta Dental and oral health coverage for citizens who purchased our coverage on the New Hampshire and Maine exchanges, but more importantly, it solidifies the medical coverage for about six million United States citizens whose medical coverage is tied to these tax credits.
It’s an easy read – and not just by SCOTUS’ decision standards- so give it a go: King v. Burwell decision.
Some excerpts of the SCOTUS’ King v. Burwell decision, released June 25, 2015:
“The issue in this case is whether the Act’s tax credits are available in States that have a Federal Exchange rather than a State Exchange. The Act initially provides that tax credits “shall be allowed” for any “applicable taxpayer.” 26 U. S. C. §36B(a). The Act then provides that the amount of the tax credit depends in part on whether the taxpayer has enrolled in an insurance plan through “an Exchange established by the State under section 1311 of the Patient Protection and Affordable Care Act…”
“The parties dispute whether Section 36B authorizes tax credits for individuals who enroll in an insurance plan through a Federal Exchange. Petitioners argue that a Federal Exchange is not “an Exchange established by the State under [42 U. S. C. §18031],” and that the IRS Rule therefore contradicts Section 36B. [citation omitted] The Government responds that the IRS Rule is lawful because the phrase “an Exchange established by the State under [42 U. S. C. §18031]” should be read to include Federal Exchanges.”
“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined—“to say what the law is.” Marbury v. Madison, 1 Cranch 137, 177 (1803). That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt. The judgment of the United States Court of Appeals for the Fourth Circuit is Affirmed.
