The U.S. Supreme Court is set to hear King v. Burwell, the case that will determine whether people in all states will receive health insurance subsidies under the Patient Protection and Affordable Care Act.
In November 2014, the Supreme Court agreed to hear the case — a lawsuit challenging the legality of subsidies under the PPACA. The PPACA states tax subsidies for health insurance are to be provided "through an exchange established by the state." Based on the text of the law, lawsuits were filed challenging an IRS regulation that allows for subsidies in all states.
Although the case isn't scheduled to be heard by the Supreme Court until March 4, major healthcare players have been sharing their thoughts on the case by filing friend-of-the-court briefs in the matter over the past several weeks.
In January, the American Hospital Association, joined by the Federation of American Hospitals, Association of American Medical Colleges and America's Essential Hospitals, filed a friend-of-the-court brief in the case. If the high court decides subsidies can only be provided to residents of states that established their own exchanges, it "would be a disaster for millions of lower- and middle-income Americans," the groups argued in their brief.
Livonia, Mich.-based Trinity Health submitted a brief supporting subsidies being provided in all states. However, if the high court decides to withdraw the subsidies, Trinity Health wants the court to delay implementations until the end of the plan year. That would give Congress an opportunity to amend the law if necessary.
Nashville, Tenn.-based Hospital Corporation of America also supports subsidies being available in all states. In its brief, HCA argued the petitioners' legal theory in the case would lead to "absurd consequences."
Nineteen deans and more than 80 faculty members from schools of public health and public health programs across the nation submitted a brief that looked at the case from a patient care angle. They argued eliminating the subsidies would "put millions of people at risk for illness and death that could have been prevented or managed with the appropriate medical care."
America's Health Insurance Plans, the chief lobby for the insurance industry, argued in its brief that eliminating the subsidies in states using the federal exchange "would leave consumers in those states with a more unstable market and far higher costs than if the PPACA had not been enacted," according to The Wall Street Journal.
The petitioners in King v. Burwell argue Congress offered the subsidies as a way to induce states to set up exchanges. However, 22 states, including the petitioners' home state of Virginia, filed a brief firmly rejecting that argument, according to The Wall Street Journal
"States selected among exchange options without clear notice that the choice would harm their citizens and disrupt their insurance markets," the states said in their brief.
On the opposite end of the spectrum, Alabama, Georgia, Nebraska, Oklahoma, South Carolina and West Virginia, a set of states dominated by Republicans, have argued the states did have clear notice of the inducement to establish their own exchanges.
Numerous other briefs have also been submitted showing support for the petitioners in the case. Mark Levin, president of Landmark Legal Foundation and conservative radio host, filed a brief arguing the executive branch exceeded the boundaries of its legislative power in allowing for subsidies in all states.
However, the briefs supporting keeping subsidies in all states include arguments that are in line with most Americans' views.
Recent Morning Consult data shows 68 percent of people in the U.S. believe health insurance subsidies should be available in all states. Those findings were similar to a Kaiser Health tracking poll that found a majority of Americans favor congressional action if the court decides subsides under the PPACA are only available in states that established their own exchange.
More articles on health insurance subsidies:
Republicans will not support preserving subsidies
Major healthcare players show support for keeping subsidies in all states
White House says GOP healthcare lawsuit is 'incoherent'