This case came before the Supreme Court on appeal, and constitutes a challenge to one aspect of the Affordable Care Act, specifically regarding whether subsidies can be provided to low-income people buying health insurance through federal exchanges. These subsidies are vital in enabling people to access affordable health care coverage.
Enforcement is not an issue in this case since the tax credits will simply continue to be provided for both state and federal exchanges.
This case is particularly important because it preserves access to affordable health insurance for millions of middle and low income Americans. The decision allowed more than 6.4 million people (and by some estimates as many as 9.3 million individuals) across 34 states to keep their subsidies, enabling them access to reasonably priced health coverage. In fact, the loss of tax credits would have affected many more than those currently receiving subsidies. Without the support of subsidies, many would not be able to afford insurance, and healthier consumers would simply forego coverage, leaving insurers with a sicker, more expensive pool of customers. This would have inevitably raised prices for everyone. Given the fierce opposition from conservatives to the ACA, this case is also significant because the Supreme Court has so conclusively read the law to allow subsidies that it gives the law robust protection from future challenges based on technical statutory interpretations.
A constitutional right to health care may not exist in the United States, and the Court in the past has been quite conservative in its interpretation of the ACA, nonetheless, the Court’s opinion in King v. Burwell, lends clear support for access to affordable health care for Americans.
Northeastern Law School Professor Martha Davis, who has followed the litigation in this area, called the decision a pragmatic one for the Court, which respects the boundaries between the Court and Congress. “Congress can amend the law if it wants to cut back on coverage,” said Davis, “and absent such an amendment, if is completely appropriate for the Court to take the underlying purposes of the Act into account in construing specific statutory language. Far from a political decision, this is a decision that takes the Court out of the political fray and applies basic legal analysis in a principled way.”
(Updated December 2015)
Thirty amicus curiae briefs were filed in support of countrywide availability of tax credits that enable millions of Americans to access affordable health care, including by the Harvard Law School Centre for Health Law and Policy Innovation, Families USA, National Health Law Program, National Education Association, National Women’s Law Center, Services and advocacy for GLBT Elders, National Council on Aging, American Federation of Labor and Congress of Industrial Organizations, Service Employees International Union, Asian and Pacific Islander Coalition on HIV/AIDs, Black AIDS Institute, Gay & Lesbian Advocates Advancing LGBT Equality, HIV Prevention Justice Alliance, National AIDS & Education Services for Minorities, National Black Justice Coalition, National Minority AIDS Council and so on. (For the full list, please see http://theusconstitution.org/sites/default/files/briefs/CAC-King-Brief%20Summaries-Govt-Side.pdf)