Another Bump in the ACA’s Road

Delayed rollout dates, confusing reporting requirements and a failed website launch. Since it was signed into law almost five years ago, the Affordable Care Act has faced its fair share of challenges.

And tomorrow it will face another one.

On March 4, the Supreme Court will hear arguments regarding the constitutionality of the legality of using individual premium subsidies under the Affordable Care Act for the 34 states that did not adopt a state-based exchange.

As Rick Bell writes on his blog, the focus of the arguments will be on six words: “an Exchange established by the State.”

The law’s opponents are fixated on those six words and their meaning as interpreted independent of the rest of the legal document. They argue that those subsidies should only be made available in the states that have set up their own exchanges.  

The government wants the larger context to be considered. It argues that those six words are a “term of art,” that incudes federally established exchanges.

If the challengers succeed in convincing the Supreme Court of their argument and premium subsidies are ended in states with federal exchanges, millions of Americans would lose coverage. The individual insurance market would also be severely disrupted, which could force the White House and Congress to renegotiate the law.

The oral arguments that will be delivered tomorrow will offer the first insight into how the justices may rule.

My colleague and I will be live blogging throughout the day’s proceedings that will include expert commentary by Workforce’s “Acing the ACA” columnist and health care reform expert Gary Kushner. Keep an eye on my “Working Well" blog starting tomorrow at 9 a.m. Central Time to check out Workforce's insight on the proceedings.