A three-judge panel of the D.C. Circuit Court of Appeals ruled that the subsidies in the Affordable Care Act can only be administered by states that set up its own health insurance exchanges.
That has led to a bevy of quick headlines declaring so-called Obamacare has been dealt a severe blow, or that it has sustained a major setback. Is that true? No, it is not.
This is the first court which has ruled this way, and this will be appealed to the full D.C. court, which is highly likely to rule like every other previous court – that subsidies are also available through the federal exchange, which represents three dozen states. What’s also true is that if this somehow made it to the Supreme Court and today’s ruling was upheld there, it would deal a serious blow to millions of Americans who bought health insurance through the federal exchange, because it would no longer be affordable for most of them without the generous federal subsidies.
Before those with private insurance through their employers get too self-righteous, most of us also receive federal subsidies for our “private” insurance. It’s just that it goes to our employers, particularly large companies and corporations, to help them make health insurance available as part of our compensation.
This ruling, even if upheld, would have no effect in states that set up its own exchanges. Unfortunately for our readers in North Carolina and South Carolina, that doesn’t include us. We live in states that have rejected billions of dollars of federal funds to provide insurance to the poor, are missing out on tens of thousands of jobs that could be created with that increased economic activity, and have elected officials who have been making it difficult for people to even find out more about their individual options.
If this is upheld months or years from now – a big if – states such as ours will have another decision to make, to help its residents receive help to buy health insurance, or to maintain a nakedly political stance against the Affordable Care Act no matter how much it hurts the poor, and middle-class among us.
A few reminders: The ACA has helped decrease the deficit more than sequestration and is projected to save the country more than a trillion dollars over the next two decades. It has already begun bending the cost curve with Medicare spending that has brightened our short- and mid-term fiscal outlook, alleviating some of the pressure to gut entitlements such as Medicare. And it has helped at least 24 million Americans in some form or another, when it comes to health insurance. That doesn’t include the millions of seniors it has helped to better afford prescription drugs.
The law isn’t perfect, as evidenced by this ruling, which was hung on a drafting error. But it has already done a lot more good than most of its critic said it ever would.