The Supreme Court cemented President Barack Obama’s signature achievement on Thursday by affirming that the Affordable Care Act intended to help all Americans who need help paying for their insurance.
In their 6-3 majority in King v. Burwell, the justices ruled that Americans are eligible for subsidies, regardless of whether their state set up its own exchange. The result preserves premium assistance for 6.4 million customers in the 34 states that rely on the federal marketplace. On a practical level, it also preserves the mandate, at the center of the law and of its controversy, that every American buy health insurance.
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“After a century of talk, after decades of trying, after a year of sustained debate, we finally made health care reform a reality here in America,” Obama said in advance of the ruling. He can be more confident that this reality will hold now that the court has dispatched with the last clear, sweeping threat to the health law.
Obama is due to give a statement about the Supreme Court’s ruling at 11:30 ET on Thursday.
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After so many other presidents have tried and failed, it has been the crowning initiative of his tenure, and he can point to concrete results, like the lowest uninsured rate in recorded history. That’s in contrast to other top ambitions that have failed — immigration reform, gun control — or remain incomplete, like the economic recovery and disengagement in Iraq. And unlike vast environmental reforms imposed through executive action, arguably Obama’s other biggest footprint, the ACA remains his most consequential collaboration with Congress, albeit along party lines in the end.
The ruling also keeps alive a searing symbol of government dysfunction: Healthcare.gov, which hosts the federal exchange. Its cataclysmic meltdown during the first open enrollment period in October 2013 – a failure of the administration’s own doing after fending off so many other threats — still prompts PTSD flashbacks in the White House. While not directly related to the health policy reforms in the law, the site’s crash undermined the public’s confidence that the government could actually deliver on its promises.
The resulting surge of tech talent resulted in a vastly improved second year, but there were still big mistakes, like the more than 800,000 people who got erroneous IRS forms related to their insurance subsidies. But the searing first-year failure prompted a behind-the-scenes overhaul in how tech is handled across the administration. If it’s successful, then functional, user-friendly federal websites could emerge as part of Obama’s legacy in the years to come.
Ahead of the ruling, Health and Human Services Secretary Sylvia Burwell said it would be time to “move on” if the Supreme Court once again upheld Obamacare. But it’s a message unlikely to be received by Republican primary voters, who polls show still hate the law as much as ever. While it won’t necessarily be a top issue, the candidates vying for their votes in the 2016 primary are likely to hew to a “repeal and replace” line.
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Thursday’s ruling means Republicans will, indeed, have to offer a replacement, since the court declined to do the politically untenable task of rescinding benefits from people who are currently receiving them. But Congressional Republicans are plotting ways to fundamentally change the law if they have an ally in the White House come January 2017. So supporters of the health law cannot truly “move on” either unless a Democrat succeeds Obama.
Obamacare squeaked through Congress on a pure party-line vote, and the reason King so imperiled the law is that there wasn’t enough support in Congress to even pass a straightforward fix to the ambiguous language — “exchange established by the state” — at the center of the lawsuit.
And there are other drafting errors in the law that undermine its goal of offering affordable coverage. The so-called “family glitch” fails to include children in some affordability calculations, meaning that while insurance might be in reach for a parent, there’s no subsidy for the kids. But Obamacare remains so toxic in Congress that a vote to fix the problem is inconceivable.
The Supreme Court allows Obama to keep his mantle as the president who reformed health care in America. But it may be his successor, with room to make improvements in a cooler political environment, who’ll get to coax Americans into actually liking it.
Read more: http://www.politico.com/story/2015/06/supreme-court-upholds-obamacare-king-burwell-119416.html#ixzz3e5j2WlsG
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