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Supreme Court ACA Ruling

NAHC President Val J. Halamandaris Reports on a Key Decision on the Affordable Care Act

The U.S. Supreme Court issued a 6-3 decision today in King v. Burwell that upheld the legality of subsidies under the Affordable Care Act (ACA) for individuals who purchase health insurance through a federal exchange. Congress, the White House, and all of America had been anxiously awaiting the ruling over the last several months. The case involved a challenge to an Internal Revenue Service rule permitting health insurance subsidies under the ACA to individuals who acquire health insurance through a state, federal, or joint state-federal health insurance exchange. The central issue was whether the language of the law permits the subsidies to individuals only if they obtain the insurance through a state exchange. Presently, 34 states do not operate a state exchange.

In a 6-3 decision written by Chief Justice Roberts, the Court held that the overall context and structure of the ACA law compelled the conclusion that the tax credit subsidy was available whether through a state or federal exchange. The Court found that Congress intended to improve access to health insurance, not make it more difficult. The Court further concluded that rejecting subsidies through federal exchanges would have had a calamitous result, the opposite of what Congress sought with the law. Chief Justice Roberts was joined by Justices Kennedy, Ginsburg, Breyer, Sotamayer, and Kagan in the majority decision.

Val J. Halamandaris, President and CEO of the National Association for Home Care & Hospice (NAHC), released the following statement on the ruling:

“Today’s ruling is the best possible result we could have reasonably expected. Any other result would have led to wholesale chaos for the health care system with people across the country being denied their benefits. The Court’s ruling essentially amounts to a ceasefire in the repeal effort.

“To be sure there are serious problems with the law that need to be addressed, with a particular focus on long-term care and more emphasis on improving chronic care management. Chronic care amounts to about 93 percent of all Medicare spending. Congress has the time and opportunity to make the necessary changes, including softening the blow of the employer mandate, which will hit many small employers hard. We will continue to urge Congress to change the employer mandate to exempt home care providers, amend the definition of full-time to 40 hours per week, provide subsidies to home care agencies, and provide tax credits to home care clients to cover the increased cost of care triggered by the employer mandate. Congress should also help states provide low-wage home care workers with health insurance through Medicaid.”