Health-care advocates are hailing the U.S. Supreme Court’s decision to uphold the Affordable Care Act in King v. Burwell.
“Today, 6 million people can find comfort in knowing that their health insurance will not be abruptly snatched away from them,” said Linda Goler Blount, president and CEO of the Black Women’s Health Imperative. ”I am pleased that the court recognized congressional intent in making health insurance available to all Americans.”
The case was essentially a war of words over legislative intent. The plaintiffs questioned whether the wording in various sections of the ACA really meant that people should be eligible for tax credits to subsidize the cost of health care purchased through federal exchanges or only through state-run exchanges.
Roughly three dozen states refused to set up exchanges, including Virginia, the home state of David King and the other plaintiffs. Because of the federal exchange in Virginia, the plaintiffs contend that they can’t get out of buying health insurance unless they’re willing to pay a tax penalty. The subsidy, which averages $268 nationally, combined with discounted coverage makes them ineligible for the ACA’s unaffordability, or hardship, exemption.
“The issue in King v. Burwell is whether state exchanges and federal exchanges are to be treated the same in order for the act to hold together as a meaningful piece of social legislation,” said Alfred Chiplin Jr., senior policy attorney at the Center for Medicare Advocacy Inc. in Washington, D.C. “People who get their health insurance through an exchange, either federal or state, are poor, unemployed or underemployed.”
And, Blount points out, many of them are women.
“For the 54 percent of women enrolled in federal marketplaces — and the 1.1 million black women also enrolled — this ruling allows them to maintain access to life-saving care, including mammograms, well-woman visits and other preventive health services that enable them to have peace of mind,” she says.
“The ruling gives women the security of knowing that they and their families have access to quality, affordable health care for generations to come.”
That’s the type of security Claudette Newsome wants to maintain. Self-employed as a business consultant in Houston, she said that 2014 was the first time in nearly two decades that she was able to afford health insurance.
Without the ruling, Newsome and the rest of the 87 percent of people insured through federal exchanges would have lost their subsidies, according to Avalere Health, which conducts business and policy analysis. They faced spikes of 122 percent to 774 percent in average monthly premiums.
If the plaintiffs had prevailed in dismantling “a set of fairer rules and tougher protection,” President Obama said, “America would have gone backwards.”
“In many ways this law is working better than we expected,” he said in a statement in the Rose Garden after the Supreme Court’s decision. “The Affordable Care Act is here to stay.”
Chief Justice John G. Roberts Jr., who voted in favor of the ACA in 2012, wrote the majority opinion in the 6-3 decision, acknowledging “more than a few examples of inartful drafting” by Congress.
However, he concluded, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.”
“If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter,” Chief Justice Roberts said. “Section 36B can fairly be read consistent with what we see as Congress’ plan, and that is the reading we adopt.”
In the dissent, Justice Antonin Scalia, joined by Clarence Thomas and Samuel A. Alito Jr., described the Supreme Court’s decision in 2012 and the current one as “somersaults of statutory interpretation.”
“The cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others,” he said, “and is prepared to do whatever it takes to uphold and assist its favorites.”
Opponents promise to continue their fight, with high-profile assistance from Republican candidates gearing up for the 2016 presidential election — from former Florida Gov. Jeb Bush to retired Johns Hopkins neurosurgeon Ben Carson, who has claimed that Obamacare is the worst thing since slavery in his speeches.
“Obamacare is a looming disaster,” Carson says on his campaign website. “I strongly support Health Savings Accounts (HSAs), which empower families to make their own decisions about their medical treatment. HSAs will also drive down health-care costs while protecting patient choice and freedom.”
Blount is just as prepared to fight for the ACA through the Black Women’s Health Imperative.
“We urge those who continue to try to attack the law, both in courts and in Congress, to instead put their energies into policies and practices that ensure that every American is able to fully access health insurance and health care that keeps individuals and families healthy and whole,” she stated.
“We hope today’s ruling also inspires governors who have declined Medicaid expansion to rethink their decision, and commit to offering affordable health care to low-income residents by implementing expansion.”
President Obama acknowledged the imperfections of the ACA, while criticizing “political football” over health-care reform. “This was a good day for America,” he said. “Let’s get back to work.”
Protecting Your Sexual Health Under the Affordable Care Act
All plans purchased through the ACA and many others cover the following preventive services without charging you a copayment or coinsurance, according to the National Coalition for Sexual Health. For more information, go to www.healthcare.gov.
African Americans and the Affordable Care Act
- African Americans accounted for 17 percent of the 3.8 million people who specified race or ethnicity when obtaining insurance through federal exchanges during the initial enrollment period from Oct. 1, 2013, though April 19, 2014.
- 7 million African-American adults between the ages of 18 and 64 obtained coverage under the Affordable Care Act as of June 2014, leading to a 6.8 percent drop in the uninsured rate of blacks.
- 8 million African Americans have been able to take advantage of expanded preventive services since the ACA’s debut.
— Source: U.S. Dept. of Health and Human Services