No rulings from Supreme Court today on Obamacare, same-sex marriage | Arkansas Blog

Monday, June 15, 2015

No rulings from Supreme Court today on Obamacare, same-sex marriage

Posted By on Mon, Jun 15, 2015 at 10:29 AM

Court watchers are checking in closely each Monday this month. Mondays are the days the Court typically announces their decisions, and among the rulings to come include cases impacting the future of same-sex marriage and Obamacare

On the same-sex marriage issue, six cases from four states have been consolidated — the Court will rule on whether same-sex couples have a right to marry and whether state bans on same-sex marriage are unconstitutional. 

The Obamacare case, King v. Burwell, has nothing at stake in terms of constitutional law, but would have a mammoth impact on policy. The case, pushed by right-wing legal activists, focuses on strict textual interpretation. Four words in the law, when read in isolation, could be read to preclude the law's subsidies and cost-sharing reductions going to citizens in states with federally run health insurance marketplaces (as opposed to state-run marketplaces). The law's supporters argue that this amounts to poorly worded language and is not the law's intent — which seems plausible since the plaintiffs' reading would radically undercut the entire purpose and operation of the law. It's worth noting that everyone involved, including the states themselves, were operating under the assumption that subsidies would flow into states regardless of whether the marketplaces were state-run or federally run. But the plaintiffs argue that, hey, those four words say what they say.   

You'll never believe this, but people's opinions about the merits of the Obamacare lawsuit seem to track closely with their opinions of the law itself. Legal arguments aside, if the plaintiffs prevail in King v. Burwell (a real possibility), around 6.5 million Americans would, more or less immediately, lose the subsidies and cost-sharing reductions that make their health care affordable. Premiums would double, triple, or quadruple overnight, and millions would have no choice but to go without health insurance. 

Arkansas is technically a federal-state partnership marketplace, but for purposes of the King lawsuit, it counts as a federally run marketplace and would lose subsidies. That would hit 48,000 Arkansans. Just for the remainder of 2015, these low-to-middle-income people would lose more than $13 million in subsidies, in what amounts to a massive tax increase (if they somehow manage to keep their suddenly more expensive insurance) or a massive benefit cut (if they don't). 

Congress could fix this issue with a one-sentence clarification. But good luck if you're hoping that Congress will fix anything. The pressure would be on the states to move quickly to state-run marketplaces, setting up a potential repeat of the Medicaid expansion fight, with individual states deciding to opt in or out on. In that scenario, those 48,000 Arkansans would be dependent on the legislature. Again, good luck.  

In full disclosure: the stakes here are personal for me. My wife and I are among the Americans who would be financially devastated if the Supreme Court rules in favor of the anti-Obamacare activists' gambit. 

The Supreme Court added a day on which they will announce decisions: this Thursday. That gives three more scheduled days total before the Court takes off for the summer: Thursday, June 18, Monday, June 22, and Monday, June 29. 

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