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King v. Burwell Update — Lawmakers await King v. Burwell ruling

King v. Burwell Update — The Affordable Care Act (ACA) was subjected to a third round of scrutiny when the Supreme Court decided to hear King v. Burwell, whose focus is the validity of the federal Health Insurance Marketplace. Lawmakers are anxious whether the court will side with the plaintiffs and invalidate the federal exchange or uphold one of ACA’s primary means of increasing health care access and affordability by siding with the federal government when it delivers its final word by the end of the month.

HHS Secretary Sylvia Burwell says it will be up to governors and Congress to respond if SCOTUS strikes down the federal health care exchange. Image of Congressional assembly during President Obama’s 2015 State of the Union address courtesy of Creative Commons and Flickr user NASA HQ Photo

Speaking at the Catholic Health Association Assembly on Tuesday, President Obama said his signature health care law “is now a part of the fabric of how we care for one another,” according to the New York Times. “It seems so cynical to want to take health care away from millions of people.”

Obama’s remarks were interpreted by many to be directed to the court’s nine justices as they near a ruling that would impact millions of people in the 37 states that use the federal exchange. They were dismissed by Republican leaders, who retorted that the president was “divorced from reality” as they argue ACA has produced more negative effects than positive. The New York Times also notes ACA and health care will be a major issue during the 2016 presidential election.

Governors and Congress will need to be the first responders if the court invalidates the federal exchange, Health and Human Services secretary Sylvia Burwell said Wednesday according to Kaiser Health News. She told the House Ways and Means Committee as the government would not be able to keep the federal exchange online or even available in a different form.

Republicans grilled Burwell over what legislation the GOP-controlled House and Senate could put together that would survive the president’s veto power. According to Kaiser, Burwell said the president will not accept any measure that calls for a repeal to ACA as part of a strategy to mitigate consumer losses if the court rules in favor of the plaintiff. Sen. Ron Johnson, R–Wis., has drafted a bill that would make federal subsidies available until August 2017, but do away with the individual mandate and other parts of ACA that have been contested by its opponents.

Kaiser has reported that Pennsylvania and Delaware are the only states that have already begun to develop alternative means of delivering federal subsidies to eligible individuals in the event the Supreme Court strikes down the federal exchange.

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GOP takes on health care programs as it passes 2016 budget, announces candidates

We’re already seeing the first real thrusts of Republicans’ strategy to take back the White House as majorities in the House and Senate pass the first Congressional budget in over five years and half a dozen of the party’s presidential hopefuls announce their campaigns for the 2016 election. The GOP has the spotlight to further its case for balancing the federal budget in part by changing Medicare and Medicaid and possibly moving closer to delivering on its promise to repeal the Affordable Care Act (ACA).

The Republican budget aims to cut federal spending by $5.3 trillion in the next decade, reducing $4.2 trillion from benefit programs that include Medicare and Medicaid. However, the Hill reports that two dozen vulnerable Republican incumbents seem to be keeping a low profile when it comes to what specific changes they would make to the programs to match the nonbinding budget blueprint. They’re not only thinking how they will counter Democrats’ opposition to their bills, but also how they will retain their voter base in the next election.

Republicans in the House and Senate are using budget proceedings and the upcoming 2016 presidential campaign to push for changes to the country’s health care program as it aims to reduce federal spending. White House image courtesy of Flickr via Creative Commons.

The Hill also notes that Texas Sen. Ted Cruz and Kentucky Sen. Rand Paul, both running for president, voted against their party’s budget plan, while Florida Sen. Marco Rubio voted in line with his party weeks after announcing his campaign. Democrats predictably voted in total opposition to the budget in the House and Senate.

The Washington Post reports that under fast-track budget rules, Senate Democrats would not be able to filibuster Republicans’ attempt to vote on legislation calling for an end to ACA. However, President Obama would be sure to veto any budgetary action that would do away with his administration’s signature health care law. It’s assumed Republicans will do something to replace ACA to respond to voter concern over losing their subsidized health insurance as a result of their action.

Bloomberg News reports that Senate Republican leaders are considering legislation that would extend the ACA tax credits through 2016 in the event the Supreme Court invalidates the federal exchange later this summer.

Some Members of Congress are quietly discussing other entitlement changes related to Social Security. According to the New York Times, Paul Ryan (R–Wisc.) and Gov. Chris Christie (R –N.J.), who has said he’s thinking about running for president, have suggested “means testing” and an increase in the retirement age to solidify Social Security. An outlier in the conservative discussions regarding entitlements has been presidential candidate and former Arkansas Gov. Mike Huckabee, who promised he would “never rob seniors of what our government promised them and even forced them to pay for” in a video announcing his second run for the white House.

As we move closer and closer to the 2016 election, talk about the major health care programs and the possible political implications of action those words may inspire, however unlikely, should only get more interesting. Agents may want to pay attention to any upcoming bills dealing with Medicare, Medicaid, ACA and Social Security in case clients voice concern based on their own perusal of the daily news.

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SCOTUS nears ruling on federal Obamacare subsidies

King v. Burwell, the latest Supreme Court case to examine the Affordable Care Act (ACA), is drawing to a close.

Speculation has arisen over the future of the federal Health Insurance Marketplace that serves most of the nation in the two months since the plaintiff broached whether language regarding the federal exchange’s role in delivering subsidies conflicts with its mission to make health care more accessible to more Americans. How lawmakers will respond to the court’s ruling, which could invalidate the federal exchange if it sides with the plaintiff, has been ruminated by Republicans and Democrats alike as momentum starts to build for the 2016 general election.

 

 

The Supreme Court is deciding whether the federally facilitated exchange that’s part of the Affordable Care Act is valid in light of unclear wording. East facade of SCOTUS building courtesy of Creative Commons

The ACA was constructed with the creation of state-run exchanges in mind, in which eligible individuals could purchase a health insurance plan with federally issued subsidies to lower their monthly premium. When only 13 states set up their own exchanges, mostly due to staunch opposition from conservative states, the federal exchange delivered subsidies to people living in the 37 states that did not set up their own exchanges. 11.4 million people enrolled in a health plan for 2015 coverage during healthcare.gov‘s second open enrollment period, which was extended with a special enrollment period due to confusion over tax penalties for not having prior coverage.

The New York Times’ Frequently Asked Questions page for the case notes the plaintiff has been persuading the court to uphold the literal interpretation of the law’s “established by the states” language to invalidate subsidies delivered through the federal exchange. As the defendant, the federal government argues “the phrase is a term of art, which Congress intended to mean both state and federally run marketplaces.” It adds that the law as whole references both state and federal exchanges as means of delivering subsidies to eligible individuals.

Though the FAQ notes a ruling in favor of the defendant could be based on the Supreme Court’s precedent in ruling that Congress ultimately decides how to interpret its own confusing language, a ruling in favor of the plaintiff would be a victory for the health care law’s opponents because it would substantially limit how the government may continue implementing ACA. A ruling in favor of the plaintiff would not equal an outright repeal of the health care law, which Republicans have repeatedly called for.

Bloomberg News commentator Noah Feldman writes the court’s recent ruling in U.S. v. Kwai Fun Wong, which upheld the concept of equitable tolling in light of unclear procedural language in the Federal Tort Claims Act, might guide the court as it decides whether the federal exchange remains a valid means of delivering subsidies in light of its own legal murkiness.

Though no official response has been prepared by Republicans, The Hill reports Rep. John Barrasso (R – Wyo.) has been leading meetings among party members to discuss what to do if the court rules in favor of the plaintiff. Conservatives have been sensitive to a change in leadership tone that supports revision rather than a total repeal of ACA; this may be the GOP’s way of  mollifying voters who are anxious about losing their coverage as multiple party members announce their run for the presidency.

The Hill also reports that Democrats in Congress, who are no longer the majority, would most likely work to pass a revision to the original language to bring direct clarity to the issue should the court decide against the Obama administration.

The court is expected to reach a decision by the end of June.

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