Supreme Court Expected to Rule by End of Month on Legality of ACA Subsidies
June 23, 2015 10:04 AM
This week or next, the U.S. Supreme Court is expected to rule on the legality of government subsidies under the Affordable Care Act (ACA) for citizens to purchase health insurance coverage on the federal exchange rather than a state-run exchange. With the decision pending, a great deal of uncertainty remains over how the Court will rule and the ramifications for the health care system with the prospect of over 6 million people potentially losing access to their health insurance subsidies.
Republicans, who control both the House and Senate, are divided over how to respond should the Court rule against the Obama administration and many are anxious about such a scenario. While the party has opposed the Affordable Care Act, many Republicans do not want to see or be held accountable for millions of people previously enrolled suddenly losing coverage.
At the same time, Congressional Republicans have voted more than 50 times to repeal the ACA and some remain eager to repeal it once and for all. Those pursuing full repeal now face a new obstacle following the release of a report by the Congressional Budget Office (CBO) last week that found repealing the law would significantly increase federal budget deficits. The CBO report stated that repealing the law would increase the federal budget deficits by $353 billion in the coming decade due to lost savings and revenue. After considering the economic effects of repeal, CBO stated the total increase in the deficit would be $137 billion over the coming decade.
Other Republicans in Congress have proposed more modest approaches but have failed to coalesce around a single strategy. Last week Republican leaders announced a plan that would delay the effect of a ruling against the administration for two years, allowing the subsidies to remain in place until 2017. In theory, this would give Congress and the states enough time to find a solution by delaying the issue until after the 2016 elections. Congressman Paul Ryan (R-WI) has proposed providing the states block grants instead of subsidies for the same two year period.
Democrats and the White House, on the other hand, have already announced that they have no “Plan B.” They very much want to protect President Obama’s signature legislative achievement, and they have made it clear they expect the Court to rule in the administration’s favor. Earlier this month, President Obama was quoted saying that it was an “easy case” and “it probably shouldn’t have even been taken up” by the Court.
NAHC Report will continue to provide updates as well as further analysis about the effects on home care and hospice should the subsidies be ruled illegal.