Health reform’s “latest” legal challenge

by Adrianna McIntyre

There’s fresh buzz in the headlines about the latest legal challenge to the Affordable Care Act—except this challenge actually isn’t actually all that new; Oklahoma filed a similar suit awhile ago, and opponents of the ACA have been making noise about challenging on these grounds for the last year. However, these are new plaintiffs.  Sam Baker summarizes the argument nicely

The latest challenge accuses the IRS of illegally implementing subsidies to help people buy private insurance. And because the administration is giving out too many subsidies, the plaintiffs argue, it is also forcing too many employers to provide insurance even in states. […]

And that’s the catch — the law specifically refers to subsidies flowing through exchanges “established by the state.” The law’s critics say subsidies should therefore only be available in state-run exchanges — not in the federal version.

“The IRS rule we are challenging is at war with the act’s plain language and completely rewrites the deal that Congress made with the states on running these insurance exchanges,” Carvin said.

If you’re interested in diving into the weeds, I did a lengthy write-up of how the challenge works a few months ago. It’s a little heavy on the legalese and wonkery, so consider yourself warned.

Is this something for supporters of the ACA to be seriously worried about? That seems to depend on who you ask. I’ve talked to multiple professors and colleagues—all of whose opinions I respect immensely—and have received mixed responses. I’m definitely keeping an eye on it, and will blog accordingly.


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Adrianna works in clinical research and is a graduate student in public policy & public health at the University of Michigan. Follow her on Twitter @onceuponA.


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