SCOTUS Upholds Obamacare Federal Subsidies: A First Glance Analysis

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[A First Glance analysis by Robert Projansky - partner at law firm Proskauer in New York, and head of the firm’s Health Care Reform Task Force - of the United States Supreme Court's June 25, 2015, decision upholding Obamacare subsidies :]

The Supreme Court ruled in favor of the Federal government, holding that although the language in Code Section 36B is ambiguous, the ACA’s overall statutory scheme and the structure of Code Section 36B itself indicate that premium assistance is not limited to individuals purchasing coverage on State-run Marketplaces.

For the time being, the ACA will move forward, individuals throughout the country will remain eligible for premium assistance and employers will remain subject to the employer mandate.

Despite ambiguity in the statute, the Supreme Court rejected its typical approach (under Chevron) whereby the Court analyzes whether an agency interpretation is reasonable in the face of an ambiguous statute. The Court instead conducted its own analysis as to the proper interpretation of the statute because of it viewed this as an issue of such “deep economic and political significance” that Congress would not have delegated it to regulators.

The Court’s interpreted the statute in this manner because it viewed doing otherwise as effectively eliminating tax credits and coverage mandates in states with federally run marketplaces, which it believes would have caused a “death spiral” in the insurance market. That result, the Court decided, could not have been the intent of Congress.

...standing alone, the implications are minimal.

The implications of the King decision are significant in the sense that a contrary decision would have had a significant impact on the implementation of ACA, placing pressure on states and the federal government to consider further action. However, standing alone, the implications are minimal. For the time being, the ACA will move forward, individuals throughout the country will remain eligible for premium assistance and employers will remain subject to the employer mandate.

Notable in the decision was the disagreement between the majority and the dissent as to when the purpose of the statute and the context in which particular provisions appear matters relative to the explicit words of the statute.

One wonders whether there will ever be another Supreme Court opinion that uses the word “Applesauce” as a sentence.

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