Supremes Take Up Obamacare Subsidies

Steven D. Schwinn, John Marshall Law School

The Supreme Court today agreed to hear King v. Burwell, the case testing the federal government's authority to issue tax credits to individuals who purchase health insurance on a federal (not state) health-insurance exchange.

We posted on the Fourth Circuit ruling (along with a conflicting D.C. Circuit ruling) here; we posted on the D.C. Circuit en banc rehearing here.

The case tests whether the IRS can issue tax credits to low- and moderate-income individuals who purchase health insurance on a federal (not state) health-insurance exchange, in light of the language in the Affordable Care Act that, read in isolation, seems to limit those credits to purchasers on an "[e]xchange established by the State."

The plaintiff-petitioners argue that the this language means exactly what it says: that the government can provide credits only for purchasers on state exchanges, not federal exchanges. The government argues that other provisions in the ACA and the broader purposes of the Act show that Congress clearly intended to offer credits to purchasers on all exchanges.

Under the ACA, the federal government can step in an establish an exchange when a state declines to. Thirty-six states are now covered by a federal exchange; the rest established a state exchange.

If the plaintiff-petitioners ultimately win, the case would strike a serious blow to the universal coverage goal of Obamacare. That's because without the credits (which are significant, $4,700 per person per year, on average), low- and moderate-income individuals may not be able to afford insurance. Given that estimates put the number of individuals who have already received subsidies at nearly 5 million, the lack of subsidies could force large numbers out of the insurance pool and drive up rates for those in the insurance pool.

Today's grant was of the Fourth Circuit decision, which upheld the subsidies. The D.C. Circuit panel decision struck the subsidies, but the en banc D.C. Circuit vacated that ruling and agreed to rehear the case. (Oral argument is set for December 17.) All this means that there was  no circut split before the Court (although there were conflicting lower court rulings, at least before the en banc D.C. Circuit stepped in).) This probably says little, if anything, about the likely result in the case. (In particular: the Court didn't necessarily take the case to reverse the Fourth Circuit.)

The Court requires the votes of four Justices to grant review. But this, too, probably says little, if anything, about the likely result in the case. (We don't know which Justices voted for review, which voted against (if any), and why.) All we know is that four or more wanted to hear it.