The Supreme Court usually deals with lofty constitutional questions, but the King v. Burwell arguments Wednesday were also grounded in some practical concerns.
If the court upends Obamacare’s insurance subsidies in June, blocking them from federal-run insurance marketplaces under the Affordable Care Act, it could be too late for states to create their own marketplaces in time for next year.
“In order to have an exchange approved and insurance policies on the exchange ready for the 2016 year, those approvals have to occur by May,” Solicitor General Donald Verrilli Jr. told the court Wednesday morning.
The Obama administration says the health law allows the subsidies to be awarded in all the states regardless of who runs their insurance exchanges. The four individuals bringing the King lawsuit say that’s illegal and the court should block the subsidies for low and middle-income Americans if they’re shopping on a federal-run exchange instead of one spearheaded by a state itself.
At stake are subsidies that 7 to 8 million Americans are currently putting toward health insurance plans. Many can’t afford the plans without the federal assistance. The Department of Health and Human Services has said it doesn’t have a way to get around a court ruling blocking the subsidies.
But one of the court’s conservative justices suggested a potential solution: Delay blocking the subsidies until the end of 2015.
“Would it not be possible if we were to adopt petitioners’ interpretation of the statute to stay the mandate until the end of this tax year as we have done in other cases where we have adopted … a statute that would have very disruptive consequences,” asked Justice Samuel Alito Jr.
There are other options, too, if the court upholds the challenge. More states could run their own exchanges and access the subsidies that way. Or Congress could alter the language of the health care law to reinstate them, although Republicans are unlikely to do that.
There will be much speculation about how the court will rule until a decision actually comes down. But both sides agree on one thing: Abruptly cutting off the subsidies to people depending on them is a bad idea.
But while the law’s proponents are using that as a chief argument to keep the subsidies flowing, its opponents say blocking them would open the door to better health care reform. Those views were evident as politicians and activists reacted to Wednesday’s oral arguments.
“Obamacare is so far beyond repair that administration officials say they have no backup plan should the Supreme Court strike down the law’s core subsidies,” said House Speaker John Boehner. “Republicans are discussing thoughtful solutions to help middle-class families and give them more control over their health care.”
“A bad ruling in the King v. Burwell case would affect millions of Americans,” said Center for American Progress President Neera Tanden. “It would be unconscionable for the court to go along with the plaintiffs’ political arguments at the expense of so many.”
