Ruling protects insurance subsidies

If we take away only one thing from Thursday’s decision by the U.S. Supreme Court to uphold President Obama’s signature healthcare law, it should be that Americans who still want that policy to change will have to push their congressional representatives to do it.

In light of the decision — the second in three years involving a challenge to a crucial provision of the law — it seems pretty clear that this court is unwilling to make any such decision.

And maybe that’s a good thing.

The court upheld, by a surprising 6-3 majority, the subsidies granted to more than 6 million Americans, including close to 1 million Texans, who enrolled for healthcare on the federal exchange created under the ACA.

States had the option of creating their own exchanges. But if they failed to do so, their residents could use the federal marketplace to purchase insurance.

Texas, along with 33 other states, did not create its own healthcare exchange.

King v. Burwell centered on the portion of the law that refers to tax credits made available to Americans with incomes between 100 percent and 400 percent of the Federal Poverty Level, flowing through “an exchange established by the State.”

The challengers argued that this language meant subsidies cannot be made available to people who live in states that did not set up exchanges but relied on the one established by the federal government.

The court found that argument unconvincing.

Writing for the majority, Chief Justice John Roberts said that while the language was ambiguous, the ultimate goal of the statute was not. And if the subsidies are not available to Americans in all 50 states, that would bring about “the type of calamitous result that Congress plainly meant to avoid.”

Such an interpretation might be a little generous, given that the Court also acknowledged that the ACA “contains more than a few examples of inartful drafting.”

Roberts also pointed out that “Congress wrote key parts of the Act behind closed doors, rather than through ‘the traditional legislative process,’” and used a complicated and arcane budgetary process to get the law through to adoption.

“As a result,” Roberts concluded, “the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.”

Still, whether you believe, as the challengers argued, that the law’s drafters were very intentional in crafting the subsidy language to coerce the states into creating exchanges, or you concur with Roberts that the law’s authors were sloppy in its construction, the court’s contention that the Congress would not have intentionally drafted a law that could potentially result in such inequity does have a certain logic to it.

It’s certainly plausible to believe that Congress is guilty of incompetence. And it’s an unfortunate truth that the political wrangling that created a window for the law’s passage also limited Congress’ ability to make much-needed changes and clarifications.

Congress should be faulted for that. Had it been more careful in crafting the legislation, these relentless legal challenges (several more are pending in lower courts) would be unnecessary.

For Texas, the court’s decision has a practical consequence: It ensures that subsidy-eligible Texans will not suffer a disruption in their healthcare coverage due to a loss of the subsidies that make such coverage possible under current law.

While some members of Congress had proposed legislation to protect people from losing their insurance in the event of adverse decision by the court, lawmakers can’t be relied upon for such policy fixes in times as politically charged as these.

The court’s decision also means that the future of the ACA will continue to be a source of debate in Congress and a key issue during the 2016 election cycle.

And, while we’re all tired of the incessant attempts by some lawmakers to repeal the law and frustrated by efforts to strip certain provisions from its text, Congress, not the courts, is exactly where the law should rise and fall.

Despite its deficiencies, only the body of elected representatives that wrote and passed it should be able to alter or overturn it through a democratic process.

If Americans would like to see that result, they need to push their lawmakers to act accordingly.

This story was originally published June 25, 2015 at 5:51 PM with the headline "Ruling protects insurance subsidies."