Cooley’s Anemia Advocacy Forum Update: ACA Court Decisions

July 23, 2014The Cooley’s Anemia Advocacy Forum (CAAF) is a Cooley’s Anemia Foundation project aimed at helping thalassemia patients and families learn how to make their voices heard on federal issues of importance to the thalassemia community. (A brochure about CAAF can be downloaded by clicking here.) Following is a report from Lyle Dennis and Katie Schubert concerning two July 22 Court decisions concerning the Affordable Care Act (ACA).

Within hours of one another, two different courts issued two completely opposite rulings yesterday with respect to whether the Affordable Care Act’s wording allows people to receive subsidies when they are enrolled in the federal health insurance exchange. One court said that the way the law is worded means that those enrolled in the federal exchange are NOT able to receive subsidies, while the other court concluded it is IS in the Obama administration’s power to allow the subsidies via the federal exchange.

Confused? Surprised? We are too! The Supreme Court could take this case up to decide, but right now it means that of the 8 million Americans who signed up for health insurance through the ACA, the 5.4 million of them who are enrolled in a marketplace run by the federal government may not be eligible for financial assistance. Under the law, each state had to either set up its own marketplace, coordinate with the federal government, or declare that it would not set up its own system and rely on the federal government to do so. This is a significant blow to the President’s signature health care law, as about 87% of those who enrolled in health coverage through the federal exchange currently receive subsidies.

Those who wrote the law say that it was a drafting error and the Congressional intent was always that those who enrolled in the federal exchange would of course be able to take advantage of the subsidies.

Although the Supreme Court upheld the ACA in previous rulings, these particular cases present a new set of legal questions, and the opposite decisions seem to line up a classic route to the Supreme Court. According to the Department of Health and Human Services, which runs and implements the ACA, subsidies won’t suddenly stop in light of the decisions – they will continue for everyone who has signed up this year. The Obama administration is already working to appeal the ruling that was not in their favor. It is expected that those who sought the ruling will appeal the case that was not in their favor.

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