What the Latest Court Ruling Means for the Future of Obamacare

Although to many people Obamacare seems like settled law and the vast majority of the people insured under the Affordable Care Act are extremely happy, the far right isn’t willing to admit their loss yet, and continue to look for ways to undermine it. Now, new life has been breathed into their efforts after a three judge D.C. circuit panel has ruled that the government cannot offer tax breaks for those who bought insurance under the federal exchange, a decision that could drastically drive up the cost of premiums for many in the country.

When the states were ordered to set up their own exchanges so people could purchase insurance, only about one third of them agreed to do so. The others either completely or partially opted out, leaving their residents to use the federal exchange instead. Now, a panel at the D.C. appeals court has stated that since the law explicitly says that there are taxpayer subsidies available to those who purchase a plan on a state exchange, in those states where no exchange was created those who bought insurance on the federal exchange technically should not be eligible for subsidies.

The ruling in itself is petty. The states that refused to set up exchanges did so because they were run by GOP governors hoping to torpedo the ACA and keep it from going into effect. That the federal exchange then picked up the slack and provided an opportunity for the uninsured in their states to still obtain coverage regardless of pre-existing conditions, as well as tap into some of the taxpayer subsidies was a small band-aid for the uninsured in those Republican states, especially since they also refused the Medicaid expansion that would make coverage more affordable.

Much like the refusal to expand Medicaid (which would cost the states nothing and would allow a multitude of people to better afford their coverage), the battle over subsidies is just another rightwing ploy to doom the ACA by making it too expensive for people to participate in. Their overall goal is to use the resentment they hope to foster to propel themselves into more offices, translating the anger of those who can’t afford insurance into votes in November, believing that they can somehow convince those voters that it was the Democrats — not the GOP — who gave them massively expensive premiums.

Luckily, those who are taking advantage of the subsidies are unlikely to be affected, at least, not yet. The White House is asking for a full circuit hearing, arguing that a state exchange is a state exchange, regardless of whether it is the state or the federal government actually running it, an argument which a separate circuit appeals upheld the same day the D.C. panel ruled the opposite.

“If I ask for pizza from Pizza Hut for lunch but clarify that I would be fine with a pizza from Domino’s, and I then specify that I want ham and pepperoni on my pizza from Pizza Hut, my friend who returns from Domino’s with a ham and pepperoni pizza has still complied with a literal construction of my lunch order,” said a 4th Circuit judge who believes the subsidies should apply to all states.

It is unlikely that the subsidies will be stripped while the law is still being argued, and a full panel review may have a different outcome. If not, a trip up the the Supreme Court may be necessary for final arbitration.

Pundits on the right are declaring this ruling the “beginning of the end of Obamacare,” a claim that seems seriously overblown. But if it somehow does come to this, and we start all over with health care reform in a new bill that applies to all states, that would be an excellent opportunity to undo some of the flaws in our current system.

With a real single payer system or Medicaid for all, and an elimination of insurance being provided by employers, all people will be able to afford quality insurance regardless of which state they live in, who is the governor, and if he or she is trying to block Medicaid expansion or subsidies. We could also remove an employer’s ability to block portions of coverage in a person’s health insurance due to alleged religious objections. And, since that removes all of the responsibility from the states as well as allows employers to avoid religious conflict, it should be something that all politicians can agree on, regardless of their party IDs.

It is unlikely that the taxpayer subsidies will get stripped from those who are on the federal exchange, nor that Obamacare will unravel as a result of the continuing onslaught of tactics to undermine it. If it does, however, maybe we can use that as an excuse to create something even better.

Photo credit: Thinkstock


Jim Ven
Jim Venabout a year ago

thanks for the article.

Dennis D.
Dennis D2 years ago

John S. Because of the ACA (Obamacare) the treatments and the entire process is going a lot more smoothly.. Sorry about your loss. I almost lost my wife under similar conditions a few years back. Because of a high deductible she had not seen a doctor prior. I was lucky to be able to rush her to the ER. With out having to call an ambulance. We couldn't afford one. Our medical insurance was not that great.

This the second time I have had a bad scare. But thankfully thanks to the ACA. We will not be quite under the gun for the medical bills.

So, yes I have more than enough reason to be thankful to the heritage foundation. That conservative think tank that came up with this idea. And for President Obama for picking up the idea making it work for every day people. Even though the republican had quietly dropped the idea as being politically expedient. Could have been the heroes instead of being the miserable party of NO!.

Mary B.
Mary B2 years ago

David F......Your post about some in the US being able to "save enough" to cover your ownd medical care and treatment is so ludicrous as to be laughable......Your wages are so low that it seems that food and housing always needs to come first.....
(most just can't shoot their meat next door)
As a "Foreigner" (as David calls Canadians) I will take our system any day.......
David is a greedy Republican who begrudges everyone else anything

BTW David.....How about those GOP Governors who "caved" and are now accepting the expansion of medicare......Gov Brewer must really be wagging her finger over that one

John S.
Past Member 2 years ago

Dennis D, sorry about your plight and hope your wife improves, but last year my wife died in the UK because the NHS did not treat her bleeding ulcer in time, she had actually been schedule to start treatment the day she died (3 months after being notified she was scheduled). Additionally, my Beterseron was not covered under the NHS, nor was one of her medications, and those 2 together cost 23,000 GBP per year.

Darryll Green
Darryll Green3 years ago

what i don't understand is why cares2 didn't say anything about the senator who filed a law suit against Obama care because congress and the senate are getting subsidies for their medical even if they don't need them-MILWAUKEE (Reuters) - A federal judge has thrown out a U.S. Senator's legal challenge to a part of President Barack Obama's healthcare law that grants health insurance subsidies for members of Congress and their staffs.

U.S. Senator Ron Johnson of Wisconsin had challenged the right of the federal government to continue making employer contributions to Congressional health insurance plans even when lawmakers and their staff purchase coverage through new Obamacare online exchanges.

U.S. District Judge William Griesbach, in Green Bay, dismissed the lawsuit on Monday, saying Johnson had failed to show he had been harmed by the regulation.

Dennis D.
Dennis D3 years ago

A correction.. It is not medicare, but medicaid she does not qualify for..

Thanks every one for your kind words and well wishes.. She is doing well and we are working our way through this. Just as I am sure many others with this do as well.

Mary B.
Mary B3 years ago

Dennis D......I am so sorry to hear about your wife's illness. The last thing anyone needs is the worry of how to pay. Seems like the US health care system somehow counts on the fact that most will mortgage their "soul" to help a loved one......

Sandra L.
Sandra L3 years ago

Dennis D., Sorry to hear about your wife. Best wishes to her recovery.

Dennis D.
Dennis D3 years ago

But here in the USA. I, and every one like me, gets to the whole burden and people like you get to say, 'not my problem.' Until you have to pay fifty dollars for an aspirin in a ER.

Dennis D.
Dennis D3 years ago

David F You want trumpet the health care in this country.. Alrighty then. Try this one on for size. my wife has been diagnosed with breast cancer. She managed to avoid the need for chemo. But is going to need 6 weeks of radiation followed by the hormonal pills.

Here is the kick in the teeth. She does not qualify for medicare. Why? Because we make to much. Even if she had it would still be the last 20% of those bills. Even though on paper our assets and income may look large. In reality I am still paying for my now deceased mother in laws final expenses. As well as several other large ticket medical bills from my wife other surgeries that my medical insurance did not pick up nor medicare fully paid for either. David, I am now looking at a very real possible bankruptcy. Breast cancer was never an issue in her family. Till now.

You say the free market is the best way to go? I call bull!!

If we lived in Canada. We would not even have these worries. Our taxes would be used in a manner that would be beneficial to both myself and every one. Instead of being the reason why medical costs keep going up. In a bankruptcy those bills would go away for the most part, if not entirely. Ultimately some one still has to pay for this, David. You and I would be the reasons for keeping those costs down through our taxes.

But here in the USA. I, and every one like me, gets to the whole burden and people like you get to say, 'not my problem.' Until you have to pay fifty dollars for an