The Supreme Court announced today that it will hear one of the many remaining legal challenges to Obamacare filtering through the courts. King v. Burwell, the case in question, focuses on whether the wording of the the ACA applies Federal subsidies to everyone who signs up for insurance under Obamacare (such as the 4.7 million currently receiving subsidies after signing up at the infamous, or just those who signed up through health care exchanges established by 14 states and the District of Columbia. tadalafil online

Why does it matter? Well, if the Court rules that the subsidies don’t apply to everyone, 4.7 million people — Obamacare’s “success stories,” as supporters of the bill might call them — will see their premiums “skyrocket.” “The thing would just die,” said Harvard economist (and Senior Health Care Advisor to President Obama for the 2008 campaign) Dr. David Cutler at a recent forum.

The case centers around the interpretation of this section of the bill, which applies subsidies only to those enrollees “which were enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act.” While the IRS ruled that the subsidies applied to the insured of all states, such a ruling is only proper if the the statute was truly “ambiguous” on the point of whether federally-chartered markets are eligible for subsidies.

The bill’s text clearly refers only to those who bought insurance through State exchanges, rather than the Federal exchange, but key Obamacare supporters contend that through the bill’s context, it applies to everyone. But does it apply to everyone? In a 2012 speech, key Obamacare architect Dr. Jonathan Gruber stated that the entire purpose of this wording from its creation was to incentivize the states to set up health care exchanges: buy cialis 200mg

Source: Business InsiderI think what’s important to remember politically about this, is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits. But your citizens still pay the taxes that support this bill. So you’re essentially saying to your citizens, you’re going to pay all the taxes to help all the other states in the country. I hope that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges, and that they’ll do it.” – Jonathan Gruber

As Michigan Law professor Nicholas Bagley notes, the fact that the Supreme Court has agreed to hear the case indicates that at least four justices believe that the King decision, which upheld the IRS ruling extending the tax credits to federal enrollees, believe that the decision may have been wrong. cialis generic online levitra and viagra together

So could the law be fixed before the Supreme Court gets a chance to rule on it? Only if the Democrats want to waste a significant portion of their diminishing political capital to bring debate on the bill back before Congress to change it. The ACA’s supporters would need to craft a bill to explicitly provide subsidies to those who enrolled under the Federal plan… against a newly-elected Republican Congress whose top man Mitch McConnell promised to repeal Obamacare “root and branch,” and whose nine new senators all campaigned on repeal. where do i get viagra in chennai

King v. Burwell comes to the Supreme Court from the Fourth Circuit Court of Appeals, where the ruling was upheld in July. On the same day, the D.C. Circuit Court of Appeals ruled the opposite in the almost-identical Halbig v. Burwell, saying that the subsidies were only applicable to State exchanges. Halbig was vacated (un-decided) by the D.C. Circuit, and will be heard again in December — at the very least providing the Competitive Enterprise Institute’s legal team (which is handling both cases) some additional practice with their argument before facing the Supreme Court.

This case represents a tangible chance that at this time next year, Obamacare could be gutted. King is scheduled to be heard in early 2015, with a decision expected in June. States without exchanges may be in for political pressure when tens of thousands of their residents lose sizable subsidies for their now-required health insurance. Can the new Republican majority come up with a solution that doesn’t make them look like villains? It’s a question that deserves serious thought as the Supreme Court hears arguments in King. Crippling Obamacare would on its surface look like a big win for Republicans, but 4.7 million people whose premiums will, on average, quadruple could cause turmoil for legislators whose seats are not yet even warm (a rare question on which I mostly agree with Brad DeLong in analysis, though not conclusions).



Interested in learning more about the various challenges to Obamacare? Back in July, the Cato Institute’s Ilya Shapiro sat down with me on LIVE to do an overview, and you can check it out in our archive or on YouTube. Don’t forget Dr. John Hunt’s guide to Surviving Obamacare, too, available for members! can cialis pills split