Since the Affordable Care Act became law in 2010, those who oppose the law have brought up several issues and legal challenges against it in an effort to undermine its implementation. While some changes have been made to the original law based on interpretations of the Supreme Court, few people continue to question the ACA's intent. Lawmakers created the new healthcare law to give people better access to affordable healthcare. One of the primary methods for doing this is through federal subsidies, which lower the cost of monthly premiums for low- to medium-income families. Now, those subsidies are being questioned by a handful of ACA opponents who feel that the law is unclear about tax credits available in state-run exchanges.
The Issue at Hand
Argued earlier this month in the Supreme Court, King v. Burwell challenges the concept of advance premium tax credits in states that use federally facilitated exchanges. The text of the law indicates to some that lawmakers intended for states to set up their own exchanges and that those states would benefit from subsidies. Opponents argue that the text of the law should be read in context with the ACA's overall intent of affordability. Here are 5 five myths associated with the upcoming Supreme Court battle.
Myth #1: The text of the law is intentionally exclusive.
Opponents of the Affordable Care Act argue that Congress intentionally left the language of the law as a threat to the states to set up their own health insurance exchange sites. In return, those states would benefit from tax subsidies to make insurance affordable for their citizens. Wydra points out that this is a false assumption, unverified and undocumented. Instead, the text of the law is a stylized representation implying that all eligible citizens will have access to tax credits regardless of who manages their marketplace.
Myth #2: The argument centers on states vs. the federal government.
When the ACA became law, opponents felt that the federal government had overstepped its boundaries by imposing a nationwide healthcare law to be administered at the federal level. The Supreme Court has already ruled that features like Medicaid expansion should be left up to individual states. The issue now is not about states' rights but about the rights of those with limited incomes to get help paying for health insurance. Most of the states agree that tax credits support their economies and improve their citizens' lives.
Myth #3: Those in the healthcare industry want the law to fail.
Healthcare reform includes all aspects of the healthcare industry, including those who practice medicine, those who provide insurance and those who work in the system in any capacity. Opponents of the law assert that the healthcare industry opposes the ACA and wants it to fail so that things can return to the way they were before its implementation. This isn't the case nationwide. Doctors, insurers, hospitals and everyone else who works in the healthcare industry recognizes the economic benefit to the ACA. The healthcare system works more efficiently with fewer sick people draining resources. The ACA allows people to get the treatments and checkups they need to stay healthy.
Myth #4: The Supreme Court could rule the ACA "unconstitutional."
Constitutionality is not at issue in this particular case. Although the ACA has been challenged on constitutional grounds more than once since its implementation, the issue at stake is whether the law provides for tax credits in states that don't run their own health insurance marketplaces. Wydra asserts that the Supreme Court is addressing "a narrow question of statutory interpretation" rather than the legitimacy of the law itself. If the court decides in favor of opponents, the ruling could devastate millions of people who need subsidies to buy insurance.
Myth #5: The justices have already made up their minds based on politics.
Any time the Supreme Court hears a case, people assume that the conservative and liberal justices will stick to their party lines regardless of the evidence. Fortunately, that's not how the judicial system works. Countless examples exist of justices ruling opposite their party's opinions, and this case should be no different. The justices will give their opinions based on the facts and evidence presented to them.