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 HealthCare.gov.
You remember HealthCare.gov, 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.
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