Tags: Alito | Supreme Court | Obamacare | solution

Obamacare May Get More Time for a Solution, Justice Alito Says

Wednesday, 04 Mar 2015 04:20 PM

Justice Samuel Alito floated the idea of giving the government more time to respond if the Supreme Court strikes down tax credits for millions of people insured under Obamacare.

Americans may be allowed to continue receiving subsidies for their Obamacare premiums until the end of the year, even if the Supreme Court rules the tax credits are illegal in three- quarters of the country, said Alito, an appointee of President George W. Bush. He spoke during arguments Wednesday on a new case threatening the Patient Protection and Affordable Care Act.

Having the tax credits in place through 2015, even if they’re struck down, would give the government time to come up with new rules or measures to keep people insured over the long term. The remarks by Alito and other justices showed they were weighing the real-world consequences of a decision to end insurance premium subsidies in at least 34 states, which the Obama administration says would cause dysfunction and turmoil for insurers, hospitals and patients.

“If it’s struck down, something will happen. Whether it’s Congress or the states or HHS, they’re not going to do nothing,” Jay Angoff, a former Department of Health and Human Services official now at the law firm Mehri & Skalet in Washington, said in a phone interview.

The case was brought by opponents of the Affordable Care Act who argue that the law only provides premium subsidies in states that have established their own marketplaces to sell coverage, called exchanges. Just 16 states have created their own exchanges, and three of those nonetheless use the federal healthcare.gov system.

The Obama administration has interpreted the law to make subsidies available in all states, no matter what kind of exchange they have.

It wasn’t immediately clear where the court leaned, as Chief Justice John Roberts, who voted in 2012 to uphold the law as constitutional, asked few questions during the hearing Wednesday. A ruling is expected by late June.

Alito’s suggestion that the court might set an end-of-the- year termination date for subsidies in healthcare.gov states was greeted somewhat favorably by solicitor general Donald Verilli, who represented the Obama administration.

“That would reduce the disruption,” he told Alito. Still, he said it was “completely unrealistic” to expect that states that lack their own exchange could build one by the end of the year. Under current regulations, for example, states must win approval from the health department by May for an exchange that would open for business in October.

The Obama administration could issue new regulations, relatively quickly, to make it easier for states to establish their own exchanges, Angoff said. But it’s not clear how easy it can be, whether, for example, states could be allowed to simply pass laws or issue executive orders declaring themselves to have their own exchanges, and let healthcare.gov run the systems for them.

“HHS has stretched the law in the past,” Angoff said. “But there are limits beyond which it can’t stretch the law.”

Justice Antonin Scalia, another Republican appointee, said that Congress could act to solve the problem. Republicans in both the Senate and House have said that they would respond to a court ruling against the government with legislation to preserve insurance coverage, but they don’t agree on a solution.

“Well, this Congress, your honor?” Verilli said, to laughter. “Theoretically, they could.”

“If the consequences are as disastrous as you say, so many million people without insurance and whatnot, yes, I think this Congress would act,” Scalia said.

Before arguments began, hundreds of the Affordable Care Act’s supporters marshaled outside the court to urge a decision preserving the law. Don Mathis, 67, of Havre de Grace, Maryland, said a ruling against the government would embolden opponents and “chip away” at the law, threatening it even in states like his that have established their own health insurance exchanges.

“Do we want the arc of health care to bend up and forward and serve more people, or regress so that there are more people who need care who can’t get it, can’t afford it?” he said in an interview.

They were countered by a handful of the law’s opponents. Donna Hurlock, 61, an Alexandria, Virginia, gynecologist associated with a group called Virginians for Quality Healthcare, said support for Obamacare meant support for government control of health care, a pernicious development.

As an example, she said that Medicare, the program for the elderly and disabled, had denied some of her patients coverage for hormone replacement therapy, against her direction.

“When I was that age I was stupid, too,” she said, as the mostly young supporters cheered and a Black Eyed Peas song played on a PA system. “Their minds are closed. They don’t want to really think about what they’re supporting.”

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Justice Samuel Alito floated the idea of giving the government more time to respond if the Supreme Court strikes down tax credits for millions of people insured under Obamacare.Americans may be allowed to continue receiving subsidies for their Obamacare premiums until the...
Alito, Supreme Court, Obamacare, solution
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2015-20-04
Wednesday, 04 Mar 2015 04:20 PM
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