Supreme Court Upholds ACA Federal Exchange Subsidies

The United States Supreme Court has ruled 6-3 to uphold healthcare tax credits and subsidies through the Affordable Care Act’s federal insurance exchange, in direct contradiction of the law as-written. This is a major court victory for President Barack Obama’s (D) administration.

At issue in this case is the structure of the Affordable Care Act, the health care reform law colloquially known as ObamaCare. Under the law, states have the option of setting up their own health insurance exchanges. If a state chooses not to create an exchange, the federal government will cover that state’s citizens via a federal exchange (the web site). Under ObamaCare, a number of tax credits and subsidies are made available to citizens—particularly those with low incomes—to make their health insurance more affordable. However, the law itself establishes these credits and subsidies only in “an Exchange established by the state . . . ,” quite clearly excluding the federal exchange.

In this ruling, the Supreme Court has claimed that the phrase, “an Exchange established by the state,” is ambiguous and should be properly understood as applying to both state and federal exchanges. The ruling appears to be based on an assumption that the intent of the authors of ObamaCare was to extend these credits and subsidies to all who qualify, regardless of what exchange they are in. This may be true, but runs directly counter to the clear text of the law. In its ruling, the court does acknowledge that the ObamaCare law contains “more than a few examples of inartful drafting,” but instead of taking the law at its word, the court has attempted to rewrite it in line with legislative intent.

A fiery minority opinion referred to the majority opinion as “quite absurd,” and points out that between this ruling and an earlier ruling where the court redefined a fine as a tax, perhaps ObamaCare should be known as SCOTUScare (SCOTUS being a common abbreviation for the Supreme Court of the United States). Indeed, we have now established court precedents at the highest level that arbitrarily redefine ‘fine’ to mean ‘tax’ and ‘state’ to mean ‘state and federal.’ This raises serious questions about whether any law can be presumed to mean exactly what it says, and about the level of authority the Supreme Court has asserted to modify duly passed and signed legislation.

The ruling was delivered by Chief Justice John Roberts, joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan. Justices Antonin Scalia, Clarence Thomas, and Samuel Alito filed a dissent.

Scott Bradford is a writer and technologist who has been putting his opinions online since 1995. He believes in three inviolable human rights: life, liberty, and property. He is a Catholic Christian who worships the trinitarian God described in the Nicene Creed. Scott is a husband, nerd, pet lover, and AMC/Jeep enthusiast with a B.S. degree in public administration from George Mason University.