Friday, June 26, 2015

The Chief Justice Saves Health Care for Us All - Again

King v. Burwell was a case so strange, so transparently and cynically ideological in its proponents' motivation, that the Court should probably never have taken it up in the first place. But then, having heard the case, the Supreme Court, by a decisive 6-3 vote, came to the clearly correct conclusion. And once again, it was Chief Justice Roberts, who stated the obvious: "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.”

In our system, the interpretation of legislative texts is inevitably one of the tasks of the Judiciary. And it can be a challenge - especially given what the Chief Justice noted are the Affordable Care Act's "more than a few cases of inartful drafting." But, in the end no matter how poorly written the statute and its infamous four words admittedly were, it was - as the Court's majority readily recognized - Congress's clear intent to increase the public's access to health insurance and to provide people with the financial subsidies necessary to enable them to purchase insurance on the exchanges that were to be created across the country. Of course, Congress probably had expected that most states would create such exchanges, as they likewise must have expected that most states would expand Medicaid. That so many states have failed to do so is a sad commentary on our pathetic politics, and on an opposition party committed to denying people access to affordable health insurance. 

Contemporary legislation tends to be very long and complex and probably contains many examples of "inartful drafting.". All the more reason, it seems to me, to take intent seriously, to take seriously what those who voted for the law evidently intended they were accomplish by passing it - in this case, making it possible for those who could not otherwise afford health insurance to do so with the help of a federal subsidy. In the end this logic was obvious to the majority of the Court - in fact, to all but its three most eccentric ideologues.

Obviously the most important result of this decision is that some 6.4 million Americans who have - in many cases, for the first time - acquired adequate health insurance thanks to the availability of federal subsidies need not now fear losing their insurance. But this result also means a further stabilizing of the new "Obamacare" status quo. It means many more Americans will continue to experience and become accustomed to the benefits of the law, which will, of course, make it harder and harder in the future for anyone to take access to affordable health care away from them. The opposition surely understands that. Everyone remembers what happened with Social Security in the 1930s. Like Social Security, "Obamacare" is now here to stay. And the nation is that much better because of it!

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