Supreme Court Hears ACA Challenge

The latest legal challenge to the Affordable Care Act (ACA) King v. Burwell was heard today in the US Supreme Court (SCOTUS).

Courtroom bloggers gave the advantage to the Obama administration, but said the justices' questioning made it clear that it will be a close vote.

“The most important news from the morning’s argument is clearly [Justice Anthony Kennedy’s] focus on the potential consequences for states that choose not to establish their own exchanges,” blogger Eric Citron wrote. That could suggest that Kennedy is more concerned about states’ rights than the prospect of undoing Obamacare. That was a key concern when the court ruled that states could not be forced to expand Medicaid eligibility.

Chief Justice John Roberts did not speak, according to the bloggers. His vote and that of Kennedy are widely seen to be swing votes.

Recordings are not permitted in the courtroom, but official transcripts are due to be on the SCOTUS site later this afternoon. The court is expected to announce its decision in June.

At issue is whether residents of the 34 states that have allowed the federal government to set up insurance exchange websites, rather than do it themselves, can get federal subsidies to help pay their premiums. If the court finds they cannot get the subsidies, about 6 million people would lose them.

The plaintiffs are 4 residents of Virginia who say they did not want to purchase ACA-compliant health insurance and (were it not for the subsidies) could not afford to do so, which would make them exempt from the part of the ACA that says individuals must have insurance or pay a penalty.

A key part of arguments is whether these plaintiffs can show they have been harmed by the law. If not, they will not have the right to be in court at all. Justice Ruth Ginsberg took up that line of questioning, the bloggers reported.

In challenging the ACA, plaintiffs’ lawyers are using the wording of the ACA’s enabling legislation to say that only exchanges “established by the State” are allowed to pass on the subsidies.

Proponents of the ACA call this a simple case of poor wording, and say that it was never the intent of lawmakers to make such a restriction.