Supreme Court Upholds Obamacare! Three Judges Dissent, Calling the Decision Absurd!

Mark this day, June 25,2015 (also my daughter’s 10th birthday) as also the birth of a new state.  Our country, according to the Supreme Court’s decision in King v. Burwell, now consists of 51 states.  The Health and Human Services (HHS) is now our 51st state.

Today the Supreme Court decided the King v. Burwell case.

If you recall, this case was to determine whether the plain language of the Affordable Care Act (ACA) should be upheld.  According to the ACA, people were to receive tax subsidies or “premium tax credits” to subsidize certain purchases of health insurance made on Exchanges, but only those enrolled in through an Exchange established by the State under [§18031]. §36B(c)(2)(A).

See blog.

“Specifically, the question presented is whether the Act’s tax credits are available in States that have a Federal Exchange.”

“At this point, 16 States and the District of Columbia have established their own Exchanges; the other 34 States have elected to have HHS do so.”

In Justice Scalia’s words, “This case requires us to decide whether someone who buys insurance on an Exchange established by the Secretary gets tax credits. You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. In order to receive any money under §36B, an individual must enroll in an insurance plan through an “Exchange established by the State.” The Secretary of Health and Human Services is not a State. So an Exchange established by the Secretary is not an Exchange established by the State—which means people who buy health insurance through such an Exchange get no money under §36B.”

However, the majority disagrees.

Apparently, HHS is now our 51st state.

The upshot of the Decision is that the majority found that, despite our country’s deep-rooted, case law precedent that when a statute is unambiguous that the plain meaning of the statute prevails.  Despite hundreds of years of the Supreme Court upholding statutes’ clear meanings, the Supreme Court, in this case, decided that “[i]n extraordinary cases, however, there may be reason to hesitate before concluding that Congress has intended such an implicit delegation.”

Therefore, when the ACA became law, and the word “state” was used, surely, Congress meant “state and/or federal government.”  Or, on the other hand, let’s just call HHS a state for the purpose of the ACA.

In Justices Scalia, Thomas, and Alito’s opinions, the decision is absurd.  In the dissent they write, “The Court holds that when the Patient Protection and Affordable Care Act says “Exchange established by the State” it means “Exchange established by the State or the Federal Government.” That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on June 25, 2015, in "Single State Agency", Affordable Care Act, Agency, Barack Obama, CMS, DHHS, Division of Medical Assistance, Federal Government, Federal Law, Health Care Exchange, Health Care Providers and Services, Health Exchanges, Healthcare.gov, HHS, Lawsuit, Legal Analysis, Legislation, Media, Medicaid, Medicaid Attorney, NC, North Carolina, Obamacare, Sec. Sylvia Burwell, Secretary of Health and Human Services, Supreme Court, Sylvia Burwell, US Supreme Court and tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink. 4 Comments.

  1. I guess 6 Supreme Court justices thought differently. It is truly a shame that our current legislative and executive branches can not work out the problems with the Affordable Care Act. You have authored several blogs about the problems with our current health care system so trying to overturn the ACA without a viable option to address the problem does not sound like a reasonable solution.

    • You are right that we need a viable option. But it’s like walking through a maze…once you realize that you are going the wrong way, you change direction.

  2. Frances Chavez MD

    Only those precious souls can afford the 100k retainer can hope to be afforded due process. Such corruption!

  1. Pingback: Well, This Changes Things: King v. Burwell and the New(?) Chevron Doctrine | Colorado Health Care Law Blog

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