Thursday, December 11, 2014

Predicting the Fallout from King v. Burwell — Exchanges and the ACA — NEJM

The challenge to premium subsidies under the ACA threatens to destabilize insurance markets and deprive millions of health insurance coverage.  Republicans are gloating over remarks by the now apologetic Jerome Gruber that support their argument.  The vote of four justices to take the case (presumably those who would have voided the entire act - you know who) leaves the fate of millions in the hands Chief Justice John Roberts.  So easy for him to kill the measure.  Everyone agrees the language is ambiguous, so they have free reign.
It is a bizarre fact of American politics that the GOP has pledged its soul to denying health insurance to millions. Only complex fixes could save those in states that have refused to set up exchanges.   And every GOP rep in congress has taken the pledge.  - gwc
Predicting the Fallout from King v. Burwell — Exchanges and the ACA — NEJM: by  Nicholas Bagley, J.D., David K. Jones, Ph.D., and Timothy Stoltzfus Jost, J.D. December 10, 2014DOI: 10.1056/NEJMp1414191
The U.S. Supreme Court's surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Care Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA.1 The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased “through an Exchange established by the State.” According to the plaintiffs in King, that language means that consumers who buy insurance through federally run exchanges don't qualify for subsidies. The Court's decision to hear the case without a split between appellate courts suggests that at least four justices harbor serious doubts about the IRS rule's validity"

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