Affordable Care Act / Healthcare / Politics

The ACA is in Trouble… Again

This past week, a federal judge in Oklahoma ruled that the federal government cannot provide health insurance subsidies in states that did not set up their own health insurance exchanges. This ruling makes it more likely that the Supreme Court will have a hearing on the issue as this is the third ruling issued on such a case (the other two cases were in Washington D.C. and Richmond, VA, with the rulings of the two being different from each other). The judge made his ruling based primarily on the English definition of the word, “state,” saying that “state” cannot mean the federal government.

3293465641_b6c5081e87_zThe English word is derived from the Latin status, meaning “condition of a country,” and now refers to “a politically organized body of people under a single government.” From this definition, it is rather clear that the judge made the appropriate ruling to uphold that the federal government cannot act in place of a state government. The power given our nation’s individual states to create and enforce their own laws has been a cornerstone of our country since it was founded. It should also be pointed out that the law, as originally written, does not explicitly declare that those plans purchased from the federal exchange are eligible for the tax credits that many individuals and families need in order to afford the insurance.

Thus, the question arises: What, if anything, can be done to ensure that the 4.5 million individuals currently receiving subsidies are not completely cut off from the federal funding that they so desperately need? The ruling mentioned that the vague notion of the law’s basic purpose cannot be used to alter the written words of the law. In taking this stance, the ruling is forcing the administration to route rule and law making through the proper channels rather than keeping everything in the executive branch. In short, if the administration wants to ensure that the consumers can still receive the subsidies, they are going to have to rewrite the law.

This requirement of a rewrite further emphasizes just how poorly written the law is. There have been several instances where the administration has stepped in to provide baseless interpretations of sections of the law that were not explicitly written. We were told during the passing of the Affordable Care Act (ACA) that if we wanted to understand what was in the law, we would have to pass it. It seems that even after its passing, our government officials are unsure as to what the law requires and allows them to do, creating situations of confusion and the overuse of power.

Rather than taking the time to figure out the effects of the law when it was being created, Congress chose to take this wait-and-see approach that could spell out the end of the law. In taking this action, Congress gave much of their power in law making to the president’s office. This is typically not done during the creation of the law. It is because of this deviation from normality that the judicial system is able to step in and correct the mistakes that are being made. Perhaps rather than forcing the law down the throat of the opposition, those who drafted the bill should have taken their time in understanding what exactly they were passing. If they did, this over-step of executive branch power and several other issues that exist because of this law could have been reduced or avoided altogether.

This ruling is not the end of this issue. There is a fourth hearing on the same topic occurring in Indiana this month, which could add even more intrigue heading into the looming Supreme Court Hearing. A Supreme Court ruling similar to the ruling handed down by the Oklahoma judge could help the Republican Party get the significant restructure of the law, or even the repeal, that they have wanted since its passing. More than that, however, such a ruling could help curb the overuse of power by the administration, moving the nation back to the Constitutional values that have successfully led our nation for over 200 years.

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