Cara L. Gallagher, Weekend Contributor
How many articles, journals, blog posts, podcasts, and Tweets does it take to understand King v. Burwell? The short answer: Several. One can easily find himself in their own “death spiral” of content, to use the parlance of the media and Justices recently, and still end up in the same place – confused, but maybe hungry for more.
I was hungry for more and followed the analyses closely, but even I got a bit lost in the weeds of the case. It’s been over a week since oral arguments were delivered in King v. Burwell, which took a second stab at the Affordable Care Act in the Supreme Court. By Thursday of last week, at least five friends and students asked me “What the heck is this case really about?” I forwarded links to articles and podcasts that delivered simple, straightforward explanations, and recommended writers to follow on Twitter. But I know some of those well-intentioned folks will never open that link, listen to the podcast, or even open the email. What to do?…
I used to write a segment called “5-cent and 10-cent rundowns” where I dissected critical Supreme Court cases into digestible, short write-ups that one could read to accomplish two goals: 1) gain an understanding of the case; 2) be able to explain the case to someone else if/when the subject came up. These rundowns are for the curious, the hardcore, or those who just want to bookmark this page to come back to in June, when a decision is likely to come down and there is a revival in interest for this case.
5-cent rundown: Can the federal government, via the Internal Revenue Service, give people assistance (tax credits) to purchase insurance through the Federal “exchange” even though the original language in the 2010 Affordable Care Act said the credits are only for those purchasing insurance on exchanges “established by the state”? This case centers on whether or not the Justices will read the law literally or take a broad interpretation of the ACA. These two dubious ways of interpreting the ACA are in essence what divides the Court. Textualists, like Scalia and Alito, are likely to follow the literal letter of the law, whereas Breyer, Sotomayor, and Ginsburg will interpret the letters, the sentence, and the broader context. Either way, this case is certain to be of consequence to the 11 million people getting their insurance through Obamacare.
10-cent rundown: If you’re a living, breathing citizen of the U.S. you have to have healthcare. That fact was established in the controversial 2010 ACA legislation. A separate, major SCOTUS case ruled this was law was constitutional. King isn’t going to impact folks who are fortunate enough to get healthcare through their employer. The core audience in this case are the 30+ million Americans who had no health insurance before Obamacare: Grad students, nannies, consultants, small-business owners, and millions of others.
Since health insurance was mandated, the ACA was written so that everyone would be able to go and get their own insurance in an open market called an “exchange.” The states could set up these exchanges or they could opt out. If your state said “Pass,” you could still go to the federal exchange and pick a provider at a price you could afford. Unless you live in one of the 16 states with its own exchange, you’re forced to get your insurance on the federal exchange. Since the federal government isn’t in the business of handing out cash, the Obama administration has the IRS provide the financial help in the form of tax credits to ease the financial burden of paying for insurance.
Dave King, a 64-year old man, and three other people from Virginia, represent the petitioners in this case. Virginia is one of the 34 states that doesn’t offer an exchange forcing residents into the federal exchange. Burwell is Sylvia Mathews Burwell, the Secretary of the Health and Human Services Department. Solicitor General Donald Verrilli is the attorney representing the government.
If you’re shocked an average-Joe like Mr. King took his case all the way to the Supreme Court, don’t be. Wealthy interest groups, think tanks, and public policy institutes scout petitioners for cases like this that, they think, are prime Supreme Court bait. In King’s case, the Competitive Enterprise Institute is supporting him and his legal team. Michael Carvin is King’s attorney and a Supreme Court advocate who argued the last Affordable Care Act case before the justices in 2012. King and the CEI want to convince four Justices, and either Kennedy or Chief Justice John Roberts, that the IRS and the Obama administration are violating the law by giving Americans in the 34 states without exchanges tax benefits therein dealing a fatal blow to spirit of the ACA.
The government’s argument asserts that King is isolating the words “established by the state” and taking them out of context. Further, it would be counterintuitive to create a piece of major legislation with four words that can internally dismantle the law. The Justices were reminded that many people can only afford to pay for mandatory insurance through the tax credits they get from the IRS. If the 11 million who’ve registered for Obamacare stop paying for their insurance because they no longer have financial support, the infrastructure of the ACA is crippled. As the ACA relies on a system in which millions of healthy people pay to offset the costs for those that are not, such a cataclysm would result in the interminable death spin for Obamacare.
I received a great question this week: “Who asked questions in the Court?” The Justices tend to save their words for challenging hypothetical tests to the attorney or side they’re most troubled by. Silence can be golden. If they’re not asking questions they’re likely, but not always, leaning towards the attorney speaking. [The only exception being the consistently silent Clarence Thomas.] The usual left-leaning justices (Kagan and Sotomayor) challenged King’s attorney while Scalia and Alito had several questions for Solicitor General, Donald Verrilli. [The Wall Street Journal had a simple, easy to read play-by-play here.]
The legal equivalent to Muhammad Ali and Joe Frazier met, again, in the SCOTUS during oral arguments for King. Michael Carvin, a seasoned Supreme Court advocate who represented the petitioners, challenged the constitutionality of the ACA in 2012 and the Florida recount in 2000, versus Donald Verrilli. Verrilli’s mild-mannered, methodical approach, juxtaposed with Carvin’s brazen defense of statutory text, make listening to the audio of the oral arguments worth it.
What’s next? A decision. Many say the justices already know how they’re going to rule by the time oral arguments happen but crafting the text of the decision – especially in close (5-4) cases – takes time. A decision is expected at the end of June, just before the end of the Supreme Court’s term.
The views expressed in this posting are the author’s alone and not those of the blog, the host, or other weekend bloggers. As an open forum, weekend bloggers post independently without pre-approval or review. Content and any displays or art are solely their decision and responsibility.
http://www.huffingtonpost.com/2015/03/20/supreme-court-obamacare-king-_n_6906064.html “WASHINGTON — Experts have a pretty good sense of what will happen if the Supreme Court rules in favor of the plaintiffs in King v. Burwell, cutting off Obamacare’s tax credits in roughly two-thirds of the states. Without that financial assistance, most of the people now buying insurance through healthcare.gov, the online marketplace run by the federal government, wouldn’t be able to pay for their coverage anymore.
A ruling wouldn’t affect people living in states like California and Kentucky, which operate their own insurance marketplaces. But the results in the rest of the country would be dramatic and visible. More than 8 million people would end up uninsured, according to estimates by the non-partisan Urban Institute. Economic disarray would follow, as panicked insurance companies hiked premiums and pulled out of markets suddenly bereft of customers.
What the experts can’t say is how people would feel about such a shock, because it’s hard to think of a time when government took away benefits from so many people, across such a large swath of the country, within such a short time. There just isn’t a great historical analogue for predicting how people would react — or, for that matter, how that reaction would affect politics. Even veteran strategists seem stumped.”
swarthoremom
Bloomberg – Some companies give only partial credit to the Affordable Care Act. They also were formed because of a related law passed a year earlier that provided federal money for hospitals and doctors’ offices to buy electronic record systems, as well as advancements in mobile and wireless computing technology.
“There’s a lot of opportunity for new market entrants,” Zenefits’ Conrad said. “The ground is literally shifting under the feet of the incumbents.” “
Zenefits is a new software company – nothing more and if it was advertised by a Conservative – it would be knocked down as making a profit off of the people.
http://www.huffingtonpost.com/2015/03/20/supreme-court-obamacare-king-_n_6906064.html “WASHINGTON — Experts have a pretty good sense of what will happen if the Supreme Court rules in favor of the plaintiffs in King v. Burwell, cutting off Obamacare’s tax credits in roughly two-thirds of the states. Without that financial assistance, most of the people now buying insurance through healthcare.gov, the online marketplace run by the federal government, wouldn’t be able to pay for their coverage anymore.
What experts? The Kaiser Foundation? Give me a break.
A ruling wouldn’t affect people living in states like California and Kentucky, which operate their own insurance marketplaces. But the results in the rest of the country would be dramatic and visible. More than 8 million people would end up uninsured, according to estimates by the non-partisan Urban Institute. Economic disarray would follow, as panicked insurance companies hiked premiums and pulled out of markets suddenly bereft of customers.
Mespo or Mike Appleton or any Lawyer here has been unable to address the question I keep asking why the rest of us that make between $30,000 and $75,000 began delaying medical care over costs more in 2014, up to 38 percent in 2014 from 33 percent last year; among households that earn above $75,000, 28 percent delayed care this year, compared to just 17 percent last year.
https://danfromsquirrelhill.wordpress.com/2013/09/24/obamacare-59/
That question is Why should people with such low incomes have to carry the brunt of the Obamacare tax that the Republican Congress and our State Representatives that are opting out are trying to protect us from by breaking the back of it and hopefully repealing the law.
This law was never designed to work. It was designed to be broken from the beginning and suck the money out of the consumer and look at all of the carpetbagger businesses springing up in the Software Business. Only they are Democrats.
.
http://www.bloomberg.com/news/articles/2015-03-20/dozens-of-startups-in-obamacare-s-wake-reveal-law-as-job-creator ” (Bloomberg) –” More than 90 new health-care companies employing as many as 6,200 people have been created in the U.S. since Obamacare became law, a level of entrepreneurial activity that participants say may be unprecedented for the industry.
Zenefits, which provides human-resources software and acts as a health-insurance broker for small employers, wouldn’t exist without the law, said Parker Conrad, the firm’s chief executive officer. Since the Affordable Care Act’s inception in April 2013, the San Francisco-based company has grown to more than 900 employees. That makes it the largest firm among dozens that have sprouted in the law’s wake, according to PricewaterhouseCoopers, which issued a report on the trend this week.
The health law, which took full effect in 2014, represents the most dramatic change to the U.S. health system in 50 years. Entrepreneurs, including some from within President Barack Obama’s administration, have founded companies that target employers, health insurers, hospitals, doctors and consumers looking to navigate new requirements and possibilities.
“There’s a lot of opportunity for new market entrants,” Zenefits’ Conrad said. “The ground is literally shifting under the feet of the incumbents.” “
Mespo
At least we can look our neighbor in the eye and know that we did not take anything away from him like this ACA thing does or all of these other pork barrel taxes that come around every time a Democrat gets in power. Now, I don’t like everything about Republicans. I don’t like their Strict Moral Code. I think they need to lighten up in the bedroom and mind their own business but as far as money goes your Macroeconomics does not work
Mespo – you DO understand that the refusal is our tax dollars do you not???? That is the little thing that you and rafflaw keep forgetting about.
The reason the Republican Senators are sitting on the exchanges are because that money is coming from small businesses – middle class people that subtract the calculation out and people that are penalized and it is morally wrong.
Okay?
Do you understand. This is why we call our Congressmen. This is why a lot of Republican lower middle class people don’t mind being poor. Because they know the score. Those with Street Smarts do anyway. Trust me I know. And don’t think I don’t have book smarts also.
Make that expand Medicaid.
Mespo here are some more facts and figures because Obamacare is so wonderful and fair to the Middle Class. The guy on this blog does exhaustive research.
310) November 2014 Gallup poll showed that Obamacare made health care less affordable, which is the opposite of what Obama had promised
President Obama signed Obamacare in March 2010. In November 2014, the Daily Caller reported:
Gallup: Peak Number Of Americans Delaying Medical Care Over Costs
One in three Americans has put off seeking medical treatment in 2014 due to high costs, according to Gallup — the highest percentage since Gallup began asking the question in 2001.
Thirty-three percent of Americans have delayed medical treatment for themselves or their families because of the costs they’d have to pay, according to the survey. Obamacare, of course, had promised that it would help make health care more affordable for everyone, but the number of people who can’t afford a trip to the doctor has actually risen three points since 2013, before most Obamacare provisions took effect.
The hardest-hit: the middle-class. Americans with an annual household income of between $30,000 and $75,000 began delaying medical care over costs more in 2014, up to 38 percent in 2014 from 33 percent last year; among households that earn above $75,000, 28 percent delayed care this year, compared to just 17 percent last year.
https://danfromsquirrelhill.wordpress.com/2013/09/24/obamacare-59/
If you don’t like Danny’s Blog – I can go find the Gallup poll (lol)
“All of these facts are relevant to the fact that Obama LIED regarding his coverup of a pathetic law”
*************
Like I said, we were talking about the gap in coverage caused by the refusal of Repubs to expand Medicare. Try to keep up.
Happy:
You’ve got facts all right, just none relevant to our discussion. We were talking about people who can’t afford ACA and the Repubs who are happy to keep then uninsured by stopping Medicaid expansion not small business tax credits. Maybe next time we’ll tailor our conversation to comport with your thimble-sized understanding of the law. Not this time though. In the meantime, you can engage in all the self-play you like.
Mespo 727272
All of these facts are relevant to the fact that Obama LIED regarding his coverup of a pathetic law. I am not a registered Republican and I voted For Obama in 2008 and still remember his Rock Star extravaganza about the Hope and the Change down by the Mississippi River in St Louis Singing about “Respect” and signing off with “Signed Sealed and Delivered”
You sound like you certainly have been keeping up. There is only one thing….. You did not read or comprehend the fact that the Tax Credit is a Debit to many people – I am certain that you looked at that simple calculation up there and saw the trickery behind it did you not???? That was pure IRS and nothing to do with a Republican.
In Fact I don’t see at all why I should stick to the Republicans when you have someone like Lois Lerner losing e mails who is in charge of the tax exempt status of organizations all the way into ACA it seems – even though we were told that would not happen in 2013 (lol) In fact – your little fact finders were telling us that Republican Senators were “Overreaching – Lois Lerner
International lawyer
Lois Gail Lerner was the director of the Exempt Organizations Unit of the U.S. Internal Revenue Service and is a notable figure in the 2013 IRS targeting controversy. Wikipedia Remember the emails and the shell game and the 5th amendment deal?
http://www.factcheck.org/2013/05/republican-overreach-on-irs/
These are the Senators they said are overreaching
While there has been plenty to find fault with in the revelation that the IRS targeted some tea party groups seeking tax exempt status, some of the Republican rhetoric has been an overreach.
Rep. Michele Bachmann falsely claimed that Americans “most personal, sensitive, intimate, private healthcare information is in the hands of the IRS,” while raising the specter that the IRS will misuse that information against “political opponents of this administration.” The IRS will not have access to personal health records.
Sen. Rand Paul passed along baseless speculation that “the person running Obamacare” was the one “who wrote the policy” at the center of the IRS controversy. That’s a reference to a former IRS commissioner of the office responsible for tax-exempt organizations who now heads the IRS’ Affordable Care Act office. But a Treasury Inspector General’s report found that employees the Cincinnati office, not any administrators in Washington, “developed and implemented” the policy in question.
Rep. Paul Ryan said that the IG investigators “didn’t look at emails, they didn’t look at intent, they didn’t look who was in the chain of information.” That’s not true. The IG office did look at emails and conducted interviews, and the report made findings about who knew what and when.
Anyway, I digress. I am always doing that and getting accused of not making any sense lolol. So. Here we are with Lois and her 30,000 emails spewing around and being picked out assiduously. Now they will have to prove they are hers. lolol. Good luck. “I plead the fifth” So, all of a sudden we are supposed to have forgotten the IRS is to keep OUT of the ACA and our tax business
http://topics.nytimes.com/top/reference/timestopics/organizations/i/internal_revenue_service/index.html
Internal Revenue Service
News about the Internal Revenue Service, including commentary and archival articles published in The New York Times.
Chronology of Coverage
Mar. 5, 2015
Personal Tech Q&A on receiving suspicious email from Internal Revenue Service; securing single folders on Apple computer with password; Tip of the Week on managing Charms bar in Windows 8.1 operating system. MORE
Feb. 15, 2015
Internal Revenue Service has program that gives taxpayers who owe back taxes way to possibly cut amount they owe, but process requires that taxpayers to make payment offer and prove they are unable to pay full amount. MORE
Feb. 15, 2015
Tax specialists are warning businesses that IRS will use greater scrutiny in differentiating between employees and self-employed independent contractors, in large part due to Affordable Care Act and its employer mandate. MORE
This is your Liberal Paper mespo.
I have a reason for bringing all of this up.
The reason is this. Why should any tax exempt business pay 7.3 percent more on their ACA tax this year, why should poor uninsured people keep accruing 1 percent and penalties on top of that and not receive the care they did in the past, why should people be forced to buy insurance when they can’t afford it when they went to an emergency clinic before mespo? Those that didn’t were on medicare. Now look what you have done. The plan is unworkable. Kerry’s plan is workable. It is in Wikipedia.
The reason the Republican Senators are sitting on the exchanges are because that money is coming from small businesses – middle class people that subtract the calculation out and people that are penalized and it is morally wrong.
Okay?
Capice?
😉
I am really distressed about this thing. Can’t we please, if we have to have insurance, fix it?
Aridog is the one that showed me the plan in Wikipedia and he used it when he worked in his office in the DOD
mespo727272
“All of these facts are relevant to the fact that Obama LIED regarding his coverup of a pathetic law”
*************
Like I said, we were talking about the gap in coverage caused by the refusal of Repubs to expand Medicare. Try to keep up.
on 1, March 18, 2015 at 7:34 am mespo727272
Make that expand Medicaid.
My last 2 paragraphs were the explanation. The first ones were the arguments for why should I have to make them considering. see below
The reason is this. Why should any tax exempt business pay 7.3 percent more on their ACA tax this year, why should poor uninsured people keep accruing 1 percent and penalties on top of that and not receive the care they did in the past, why should people be forced to buy insurance when they can’t afford it when they went to an emergency clinic before mespo? Those that didn’t were on medicare. Now look what you have done. The plan is unworkable. Kerry’s plan is workable. It is in Wikipedia.
The reason the Republican Senators are sitting on the exchanges are because that money is coming from small businesses – middle class people that subtract the calculation out and people that are penalized and it is morally wrong.
Okay?
Capice?
Mespo…I’ll agree, in part at least, without your “compromise” assertion if and only if this Congress, House and Senate, can pass a formal 12 appropriation bi-partisan budget for 2016….instead of the easily fund gerrymandered CR’s we’ve had for 7 years now. Now if only the denizen of the WH will sign it. I’m not holding my breath on that last point.