Supreme Court decisions are often a long time coming.  The issues must be debated and researched, and then debated and researched again.  Supreme Court Justices don’t always agree on an issue, either, which complicates the matter, but our Constitution indicates that majority rules, and luckily there are an odd number of Supreme Court Justices.

King v Burwell, 2015, is the most recent court case to challenge the legal status of the Affordable Care Act (also known as Obamacare).  King, along with three others, challenged Burwell (Secretary of Health and Human Services) in a court case that was heard in March of 2015.  The issue at stake was federal subsidies used to keep health care exchanges afloat in states that did not expand their Medicaid programs.  The Supreme Court already ruled in 2012 that states cannot be forced by the federal government to expand their Medicaid program.  Some states did expand Medicaid – offering it up to people who did not necessarily qualify financially, but choose to buy into the program for lack of other choices.  Other states did not expand (see resource below), so the federal government created “exchanges” and provided tax credits to those who purchase insurance through the exchanges (see resource below).  Using a price calculator, shoppers can determine if they qualify for these subsidies.

The issue in King v Burwell was that the original language of the Affordable Care Act granted states the right to create and fund exchanges, but not the federal government.  So, in essence the federal government was overstepping its bounds.  In the ruling this past June, the majority of the Supreme Court Justices decided that the wording of the Act was ambiguous and that the intent of the law was to provide “affordable” health insurance, not punish those who could not afford it.

It is certain that many more challenges to the Affordable Care Act are yet to come.  With a change in administration certain to occur in 2016, it is inevitable that more issues will arise, along with possible policy change.  For now, health insurance exchanges will continue as an option to those who do not have health insurance provided to them by employers and/or do not qualify for their state Medicaid coverage.

More information:

State policies:

http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/

Federal exchanges:

http://obamacarefacts.com/obamacare-health-insurance-exchange/

Valerie J Connor, MA CCC-SLP