Affordable Care Act

Zubik v. Burwell, involving religious nonprofit objections to providing notice objecting to the Affordable Care Act’s (ACA) birth control mandate, does not directly affect state and local government. But it is one piece of a litigation puzzle over this law; most of the puzzle pieces do affect state and local government. In a three-page unauthored opinion the Court did not rule on the merits of the case leaving the lower courts to “resolve any outstanding issues.”

The ACA regulations requires employers offering health insurance to cover certain contraceptives unless employers object on religious grounds. Religious nonprofits claim that submitting a form to their insurer or the federal government saying they object to providing contraception coverage on religious grounds violates the Religious Freedom Restoration Act.  

A challenge to President Obama’s immigration deferral program and (another) challenge that could harpoon the Affordable Care Act (ACA) could make it on the Supreme Court’s docket this term and be decided by the end of June.

For the first time at the Supreme Court’s private conference on January 15 it will consider petitions in United States v. Texas (immigration) and Sissel v. Department of Health and Human Services (ACA).

The Court will have three choices: grant the petitions, deny the petitions, or postpone making a decision until a later conference. If it postpones a decision in either case, it must decide at the January 22 conference to accept the cases or they will be heard next term (assuming the petitions are ultimately granted). 

Recently, the Supreme Court’s already interesting docket got even more high profile. First, it agreed to decide whether the Affordable Care Act (ACA) birth control mandate violates religious nonprofits rights. Then, it agreed to decide whether a Texas abortion law is unconstitutional.

In 6-3 decision the Supreme Court ruled today that health insurance tax credits are available on the 34 Federal Exchanges. The Court’s opinion focused largely on the consequences of ruling to the contrary:  the destruction of health insurance markets.

Chief Justice Roberts, writing for the majority, began his opinion by pointing out that the Affordable Care Act relies on three reforms:  making sure health insurance is available to everyone regardless of their heath and not charging higher premiums depending on health, requiring everyone to be insured, and offering tax credits to those with low-income so they can afford insurance. If only the first reforms were implemented a well-documented economic “death spiral” occurs, where health insurance premiums skyrocket, because only the sick buy insurance.

For Justice Kennedy it was his questions, for Chief Justice Roberts it was his silence…

Today the Supreme Court heard oral argument in King v. Burwell, where it will decide whether federal health insurance exchanges, operating in 34 states, can offer subsidies to middle and low income purchasers of insurance under the Affordable Care Act (ACA). 

Simply put, the Court must decide whether it agrees with the Internal Revenue Service (IRS) that the following statutory language, “established by the State,” can include federal exchanges too.

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