In a 6–3 decision, the Supreme Court has upheld the legality of Obamacare subsidies for federally-run exchanges. At issue was language in the law that seemed to limit subsidies to Americans who enrolled in state-run exchanges—when about three dozen states did not set up their own exchanges but delegated that to the federal government. Chief Justice Roberts wrote the majority decision, arguing that the context surrounding the ACA should be used to interpret the contested language. NYT:
Chief Justice Roberts wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he added. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”
We at TAI were never too confident that SCOTUS would rule against the law. This will no doubt be a big PR victory for the ACA, and the nation might be growing weary of more debate about a law that has now twice survived the Court. That fatigue could very well work in the ACA’s favor.But this legal challenge was always quite orthogonal to the main issues surrounding the ACA. The big metrics by which we should evaluate the ACA are how well it fixes the fundamental issues making U.S. health care unsustainable and how much it improves the health care experience of patients—and whether any gains made on either score could have been achieved with a different, less complicated reform. That is the conversation we should be having about the ACA, and with this case behind us we could now focus on it again—if we have the will to do so.