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Why Obamacare will survive

By Jay MacDonald ·
Friday, July 25, 2014
Posted: 6 am ET

I suppose we've gotten used to a certain amount of Chicken Little whenever a challenge to one sentence or another within the expansive Affordable Care Act manages to convince a court that a great injustice has been visited upon the American people in the name of Obamacare.

But rest assured: The sky is far from falling on health care reform as a result of Tuesday's ruling by the U.S. Circuit Court of Appeals for the District of Columbia.

In Halbig v. Burwell, the three-judge panel agreed with plaintiffs that a single phrase within the law that states that federal subsidies should only apply to health plans purchased through "an exchange established by the state" should void the subsidies of the majority of applicants who purchased health insurance via

You remember, the iconic ticking-clock federal site that nevertheless accomplished the heavy lifting for 36 states not operating their own exchange. It managed to carry more than 8 million Americans to affordable health insurance, many for the first time in their lives.

An issue far from settled

I happened to be on the phone with two health policy experts when the ruling came down. The ever-game Deborah Chollet, a senior fellow at Mathematica Policy Research in Washington, D.C., expressed what most in her field were feeling: "Déjà vu all over again." Obamacare has been through tougher court battles, after all, including the 2012 U.S. Supreme Court smackdown for its very existence, and come away largely unscathed.

Dylan Roby, an assistant professor of health policy at UCLA's Fielding School of Public Health who was commuting through L.A. traffic as we spoke, had a bit more time to reflect.

"The important thing to remember here is that this is a three-judge panel making the decision to overturn a previous appellate court decision, and the Washington, D.C., district court has an 11-judge panel that could come in and decide to re-hear the case and override that decision. So this isn't even the final word out of the D.C. district court," Roby explains.

Another high court battle ahead?

Given the decision that dropped later that morning in the Fourth Circuit Court of Appeals in Richmond, Virginia, dismissing the plaintiff's case as "murky," most assume these and two other pending challenges will once again wind up in the laps of the Supreme Court.

But Roby isn't so sure.

"This case was brought by a libertarian think tank, so I'm not sure that the Supreme Court will even decide that they have standing in the case," he says. "In one of the decisions that came down from the Supreme Court recently, even Justice (Antonin) Scalia said you can't single out one provision or statement from the law and look at it independently from the statutory meaning of the law."

Besides, Roby says the feds step in when the states fall short all the time, whether it be Medicare, Medicaid or mismanaged community health centers, without anyone yelling, "Foul!"

To somehow deny millions of low-income Americans the subsidies they need to make health insurance affordable based on word choice would not only seem unfair, it would fly in the face of the very intent of the Affordable Care Act.

Here's a look back at the Supreme Court's landmark 2012 Obamacare ruling.

Follow me on Twitter: @omnisaurus

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Sarah Cooper
November 07, 2014 at 7:31 pm

I have not seen anything Affordable. And it is true that the insurance doesn't cover very much with a high deductible and out of pocket. It's basically a card that will get you into the doctor or hospital. I stuck with my health insurance thru my employer and they had to raise all of the above to meet "gold" standards. I personally would like to see an insurance plan where you could opt out of certain coverages like pregnancy or prostate care. (if female)

August 03, 2014 at 10:42 pm

I don't care if Obamacare survives or not. Actually I think America deserves it for choosing such a "leader" as Obama. America can not and will not survive by rejecting God at every turn. Obamacare, just like its namesake, is anti-free market. Those who don't understand that deserve what they get, a socialist plan that rips at the very fabric that made America once great. Obama is not the cause but rather the symptom. People get the leaders they deserve.

August 03, 2014 at 10:06 pm

Obamacare is terrible for many and those that think it is so wonderful now will probably be surprised when they actually have to use their ins. The deductibles are usually so high that the ins. doesn't pay anything out. Their premiums are low for a reason, they don't cover much. The ins. that I am offered is not affordable to me. I have to pay for office visits, glucose strips, insulin pump therapy, all out of pocket. I get my insulin free thru the manufacturer. With ins. I would still have to pay for everything I do now and pay a premium on top of that. It would make it harder for me to pay for my care. Because my husband's employer offers ins. I am not eligible for subsidies and to have me added to his ins. would cost more than double the amount he pays just for himself. The ins. is deemed affordable if the amount the employee alone pays is within 8% of his income but it is not fair if the added individual is charged so much more. I will not buy ins. until it is affordable, how can I?

August 03, 2014 at 6:24 pm

“A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship. The average age of the world's greatest civilizations has been 200 years. These nations have progressed through this sequence: From bondage to spiritual faith; From spiritual faith to great courage; From courage to liberty; From liberty to abundance; From abundance to selfishness; From selfishness to apathy; From apathy to dependence; From dependence back into bondage.”
― Alexander Fraser Tytler

August 03, 2014 at 2:20 pm

all insurance companies make $200 million or more profit a yr, none goes to better healthcare. no new antibiotics are being created here, no profit in it. Is that the healthcare we want -profit and greed over care. The care in Europe may not be perfect but the pay or die care here sucks

August 03, 2014 at 2:29 am

all of you crybabies out there crying about how bad aca" IS CYR on.if you are too stupid to kick your governers buts,quit votting against your on intrest.then cry on (dummies) MR WILSON