THIS SUMMER’S ATTEMPT to dismantle the Affordable Care Act began as the very height of frivolous lawsuits. Cooked up with the help of the Competitive Enterprise Institute, a libertarian think tank, the case (King v. Burwell) depended upon a very narrow reading of four words in Section 36B of the ACA: “established by the State.”
Essentially, Obamacare foes argued that Congress intended to provide health-care subsidies (or tax credits) only to those Americans living in states with state-operated insurance exchanges. Those who lived in states without exchanges—including Florida, Texas, Wisconsin, and others—and were, therefore, dependent upon the federal exchange would be ineligible for subsidies.
Of course, Congress intended no such thing—as the Supreme Court upheld. Throughout dozens of hearings and hundreds of hours of debate, it was clear that ACA subsidies would be available to every American, regardless of what state they lived in.
In a 6-3 ruling, the court rejected King, with Chief Justice Roberts explaining, “A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.”
Had the suit carried the day, 6.4 million Americans would have lost their subsidies. In all likelihood, they would no longer have been able to afford health insurance. But the ACA survived. For Christians, this was a win in defending access to health care for the most vulnerable, a key tenet in Christian social ethics.
Conservative opponents predictably protested what they called runaway judicial activism. Most notable among these was Justice Antonin Scalia, whose dissents are becoming more bizarrely dystopian by the year. Scalia warned of the menaces of “interpretive jiggery-pokery” and called the majority’s reasoning “pure applesauce.”
The Republican leadership in Congress said all the expected things and threatened to hold the expected meaningless protest votes. With majorities in both the House and Senate, they may even manage to pass a repeal of the ACA in this year’s budget process. Such a repeal would promptly draw a presidential veto that would easily be sustained. And that will be that for now.
Meanwhile, out on the campaign trail, the seemingly endless parade of presidential candidates are making their views known. Democratic frontrunner Hillary Clinton praised the court’s decision and urged everybody to move on. Vermont Sen. Bernie Sanders used the occasion to renew his call for a “Medicare-for-all” single-payer system.
Former Arkansas Gov. Mike Huckabee’s comments were typical of the Republican response, calling the decision “an out-of-control act of judicial tyranny.” Texas Sen. Ted Cruz asserted, “I remain fully committed to the repeal of Obamacare—every single word of it.”
For his part, the president hailed the decision on Obamacare as a “victory.”
“The Affordable Care Act is here to stay,” said President Obama of his most important domestic policy achievement. His administration will spend the next 18 months trying to make the ACA work as well as possible for as many people as possible, to weave it even more deeply into the fabric of the nation’s health-care system.
Conservatives such as Barry Goldwater and Ronald Reagan in the 1960s warned of the dangers of what they called socialized medicine, the supposed threats to liberty and freedom inherent in the program that came to be known as Medicare. Today their ideological successors recoil at the suggestion that anyone would tamper with such a sacred trust. Those vying for the 2064 presidential nomination will undoubtedly likewise embrace Obamacare as an indispensable pledge from a government to its people.
By then, we might even know what “jiggery-pokery” is.
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