Hundreds of millions of Americans are not entitled to government health
insurance subsidies under Obamacare because of the way the law is
written, a divided three-judge panel of the D.C. Circuit Court of
Appeals ruled Tuesday.
In
a decision that could blow a massive hold in President Obama’s
signature domestic achievement, the court held that people living in
states that relied on the federal government to set up their insurance
market exchanges cannot offer the subsidies considered critical to
making coverage affordable.
The D.C. Circuit Court of Appeals ruled the administration used
an IRS rule to stretch the meaning of the Affordable Care Act, which
said financial aid to to low- and middle-income people should only flow
to exchanges “established by the State.” If that means only state-run
exchanges, it would cut off subsidies to two-thirds of the nation.
The Obama administration is sure to appeal the circuit’s decision in the
case, Halbig v. Sebelius, because the subsidies are a huge draw for
Obamacare customers. Without that selling point, the reforms would effectively collapse under the weight of premiums that are no longer affordable.
Under the court’s ruling, only the 14 states and the District that have
taken on the responsibility for their exchanges would be able to dole
out premium tax credits to their resident.
Other states, most with Republican governors or state legislatures,
refused to set up the exchanges, forcing the federal government to step
in for them.
The
complaining individuals and entities were from states that opted not to
set up their own health exchanges. To buttress their argument, they
said the subsidies produced a ripple effect in which they were no longer
insulated from the law’s twice-delayed employer mandate, a rule that
requires companies with 50 or more full-time employees to offer health coverage or pay fines.
The rule is triggered once an employee takes
advantage of government subsidies on an Obamacare health exchange.
Without any subsidies, the plaintiffs reasoned, they would not have to
worry about the employer mandate.
The Obama administration argued that Congress always intended the Health and Human Services Department
to “stand in the shoes” of states that decided not to run their own
marketplaces. That’s what it did during the law’s first enrollment
period, setting up HealthCare.gov to serve the three dozen states that
deferred to the federal government.
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