By Ron Shinkman, Editor, Laboratory Industry Report
The United States Supreme Court ruled Thursday to maintain income-based subsidies that allow millions of Americans to purchase individual health insurance policies from the federal healthcare.gov insurance exchange.
The 6-3 decision in King v. Burwell, authored by U.S. Chief Justice John G. Roberts, Jr., deferred to the legislative intent of Congress when it drafted and passed the Affordable Care Act more than five years ago. The case centered around one sentence in the law suggesting that subsidies should only be offered through health insurance exchanges established by individual states. Declaring that sentence ambiguous, the Court said it must look to the “broader structure of the Act” to interpret its meaning. In doing so, the Court found interpreting the language to exclude subsidies for individuals enrolling in the federal exchange would “destabilize” state insurance markets and “likely create the very ‘death spirals’ that Congress designed the Act to avoid.” Over 30 states provide individual health insurance policies through the federal exchange. A study released last year by the Urban Institute concluded that an adverse ruling in King v. Burwell would have eliminated subsidies worth $28.8 billion to 9.3 million people, likely causing many to give up their coverage. That loss of coverage could have a significant impact on the laboratory sector, as some larger laboratory ventures have reported moderate volume increases connected to the Affordable Care Act—though a significant amount of those increases have been connected to the expansion of Medicaid eligibility in many states.
Justices Samuel Alito, Clarence Thomas and Antonin Scalia cast the dissenting votes in the case. Scalia read his dissent from the bench after the decision was announced, suggesting his deep disagreement over the decision, which he called the result of “interpretative somersaults” and ultimately “absurd.”
For more detailed discussion of the Court’s decision, see the next issue of National Intelligence Report.