Supreme Court Upholds Insurance Subsidies for All Americans

The state of healthcare in America became a little more secure today, as the Affordable Care Act survived its second Supreme Court case in the past three years.

The 6-3 ruling ensures Americans in all 50 states will continue to receive insurance premium subsidies under the Affordable Care Act.

Related Post: Podcast Covers King v. Burwell Decision And Fallout

It’s a significant victory for the law, as President Barack Obama stated in his address at the White House following the decision.

“Today … after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said.

The Supreme Court case King v. Burwell hinged on whether those Americans who purchased insurance plans through the federal exchange were considered eligible for the same subsidies as those who purchased plans through individual state exchanges.

Chief Justice John Roberts wrote the opinion for the court, joined by frequent swing vote justice Anthony Kennedy and liberal justices Ruth Bader Ginsberg, Stephen Breyer, Sonia Sotomayor and Elen Kagan.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he affirmed. “If at all possible, we must interpret the Act in a way that is consistent with the former and avoids the latter.”

As many as 34 states did not establish their own individual exchanges, and instead elected to use the federal exchange. Had the Supreme Court ruled in favor of the plaintiff, citizens in all of these states would have lost their subsidies and would likely no longer have been able to afford coverage.

The Department of Health and Human Services estimated about 6.4 million Americans would have lost subsidies if this were the court’s decision.

In the report, Roberts acknowledged the ambiguity of the law’s text overall, but stated that the court considered the broader intent of the law for the ultimate decision.

“The statutory scheme compels us to reject petitioner’s interpretation because it would destabilize the individual market in any State with a Federal Exchange, and likely create the very ‘death spirals’ that Congress designed the Act to avoid,” he wrote.

Justice Antonin Scalia wrote the dissenting opinion on the case. He asserted it was not the job of the Supreme Court to clarify or clean up Congress’s sloppy law drafting.

“Today’s interpretation is not merely unnatural; it is unheard of,” Scalia wrote. “Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’?”

Even with this victory, though, the Affordable Care Act still faces many challenges in the future, including proposed legislative changes currently moving through Congress as well as other lawsuits currently in the lower courts.

However, some do think this decision will discourage judges from advancing cases for future Supreme Court consideration.

Related Post: Future for SCOTUS Still in Turmoil After Nomination

“It sends a message to the lower courts that they need to take a good, hard look at all the ACA litigation that’s out there and probably clean up and get rid of most of it,” Timothy Jost, a law professor at Washington and Lee University and an expert on the health law, said to the Kaiser Family Foundation.

Overall, experts agree the decision is a step toward stability for healthcare in the U.S., but it does not mean the law is finished evolving.

Drew Altman, a columnist for the Wall Street Journal Think Tank, wrote his primary concerns following the decision.

“Significant challenges remain for the ACA, including: reaching those who are uninsured; stabilizing premium increases in the marketplaces as insurers get a better handle on risk pools; and determining which of the Medicare payment and delivery reform projects implemented under the ACA are working and should be scaled up,” he wrote.

So, the law continues to be a work in progress, a fact even President Obama does not deny.

“Let’s be clear, we’ve still got more work to do to make healthcare in America even better,” he said. “This was a good day for America. Let’s get back to work.”

Podcast Covers King v. Burwell Decision and Fallout

The country has arrived again at an important moment for President Obama’s health care law, the Affordable Care Act.

By the end of this month, the Supreme Court will make its decision on the King v. Burwell case, which challenges the eligibility of citizens to receive tax credits for insurance premium, known as subsidies, in states using the federal insurance exchange.

Related Post: Supreme Court Upholds Insurance Subsidies for All Americans

This week, Tom Quigley talked about the court case during the biweekly podcast Cutting-Edge Benefits by ClaimLinx.

He said he wasn’t surprised there have been so many challenges to the law because it was so rushed.

“They passed the law without reading it, and they even admitted it, saying that this law is so good we’ll have to read it after we pass it,” Tom said during the podcast. “This is what happens — Little words, people challenge it.”

This case focuses on the words “established by the State” in a subsection of the law, which those bringing the case say make clear that subsidies are only available to those individuals living in the states that have created their own exchanges.

Should the Supreme Court vote in favor of the challenge, millions of Americans in 34 different states will lose their subsidies and will likely no longer be able to afford health insurance.

“To me, this case is pathetic,” Tom said. “Everyone knows the intent of what the law meant, and here we are. There’s more important things in this country right now than taking away health insurance from millions because of four words.”

Related Post: Future for SCOTUS Still in Turmoil After Nomination

Tom talks about issues in health care every other Thursday during a podcast, and anyone can call in with questions or comments. Follow the show on Blog Talk Radio for reminders and updates on upcoming topics.

“The health law is like a yo-yo, it goes up and down and all around,” Tom said. “No one knows where it’s going.”

But listening to the show can at least explain it.

Congress Passes First Joint Budget Agreement in 6 Years

For the first time since 2009, Congress is in agreement on its fiduciary goals for the country. This month, the Senate passed a budget agreement, the first joint budget resolution to be passed in six years.

Related Post: Senate digs into why drug prices are so high

The proposal passed 226-197 in the House of Representatives and 51-48 in the Senate. All Democrats in the House and Senate voted against the agreement.

The proposal outlines deep cuts in domestic spending to eliminate the deficit within the next 10 years. It keeps in place the across-the-board spending cuts known as the sequester, but adds nearly $90 billion to a supplemental war fund that is not held to the budgetary curbs.

“No budget will ever be perfect, but this is a budget that sensibly addresses the concerns of many different members,” Senate Majority Leader, Mitch McConnell, said in a press conference.

There are, however, few indications these spending cuts will take hold in the immediate future. Budget resolutions are used as an outline to set spending levels on future separate appropriations bills.

President Barack Obama has said he will not sign any spending measures that keep the sequester in place. He has also said he wants to see equal increases in military and domestic spending.

White House press secretary John Earnest said the budget proposal would hurt middle-class families, which rely on the domestic programs Republicans hope to cut.

Related Post: Budget Deal Cuts Potential Health Law Tax Revenue

“Congressional Republicans propose drastic cuts to programs that support the middle class and provide ladders of opportunity for those seeking to reach the middle class,” he said.

Also included in the budget was a procedural tool for passing bills known as reconciliation. This measure allows for legislation to pass through both chambers of Congress with a simple majority vote. Most bills will require 60 votes to overcome procedural challenges, and Republicans currently control 54 seats.

Republicans say they plan to use this tool to repeal parts of the Affordable Care Act, despite the Obama’s vow to veto any legislation intended to unravel or repeal the health care law.

Listen to Tom Quigley Talk About Obamacare on ClaimLinx Podcast

It’s been said leaders should “be a voice, not an echo.”

Well, ClaimLinx has found its voice and is broadcasting it on Blog Talk Radio.

ClaimLinx now records a biweekly podcast, Cutting-Edge Benefits, which puts traditional health insurance buying on the chopping block. During each show, Tom Quigley, National Business Consultant, covers important topics business owners need to know so they can make informed health care decisions.

Related Post: ClaimLinx Launches Podcast Digging Into Traditional Health Insurance

The next episode of Cutting Edge Benefits will be recorded today at 4 p.m. Listen live or call in with questions as Tom takes a look back at the past five years with the Affordable Care Act.

Previous episodes have covered topics such as deciphering the difference between benefits and insurance.  Listen to the entire show, during which Tom said:

“Insurance should take away catastrophic risks that owners don’t want to take on. And also, with the new Affordable Care, preventative risks and all the benefits within the health insurance plan must cover the ten essential benefits with no limits.”

“Why are you offering benefits? And if the answer is to provide better benefits than the competition and take care of your employees, why would, every year when the broker comes out, would you go from paying $10,000 a month to $11,000 a month? And it would have been $13,000 a month but you decided to raise the deductible from $1,000 to $2,000 and your copays go from $25 to $35.  Why do you keep doing the same thing over and over again? Owners, you have to step up to the plate, get involved. This is an owners’ decision, with a CFO, CPA or tax attorney who understands the new Affordable Care Act. It is a huge opportunity for business owners to provide better benefits at a fraction of the cost.”

In the next episode, he went on to discuss who exactly should be in the room making these decisions. You can still listen to the full episode, when Tom said:

“Health insurance wasn’t a top ten expense 20 years ago. It has become, in some cases, a top three expense for companies. The problem is the owners need to be involved in every aspect of their business, when it comes to their balance sheet and the top three expenses. What they’ve done is they’ve allowed people within their company to make the decision and it’s becoming a major, major headache not only for the owner, but also for the employees. The decisions made with the new tax law called the Affordable Care Act are some of the worst decisions I’ve seen in the last twenty years in this business.”

Related Post: Tom Quigley Breaks Down Employee Expectations for Benefits

“There’s a problem in this country starting in Jr. High. They should be teaching these kids about finance and insurance and things that they need to know. Because you have people running around this country who don’t understand that buying a $20 copay from an insurance carrier makes absolutely no sense. It would be like buying oil change insurance for your car or plumber’s insurance for your home … and it boils down to education.”

Follow Cutting-Edge Benefits by ClaimLinx on Blog Talk Radio or Twitter for updates on new episodes. Look for #CLVoice for more information.

After Five Years With The ACA, Approval Is Low But Success Is High

The end of March marked the five-year anniversary of the Affordable Care Act being signed into law by President Barack Obama.

“It’s working despite countless attempts to repeal, undermine, defund and defame this law,” Obama said in his speech during the anniversary ceremony on March 23.

The Affordable Care Act is responsible for a number of significant changes to health care requirements for insurance companies, employers and individuals.

Related Post: Another Affordable Care Act Mandate Delayed

Insurance companies are no longer allowed to deny coverage because of a preexisting condition. There are no longer any annual or lifetime limits. Preventative care is now covered at no cost. Companies are no longer allowed to charge women at higher rates than men, and any young adult is now allowed to stay on his or her parent’s plan until turning 26 years old.

Regular individuals are now required to have coverage for a majority of the year or pay a penalty tax. Likewise, employers with more that 100 full time employees are now required to provide an affordable plan or pay a tax penalty.

All the while, these changes have been met with constant disapproval and derision. Even now, the future of law is uncertain, as the Supreme Court is expected to make a decision on the case King v. Burwell, which could have drastic effects on peoples’ eligibility for subsidies.

And the now GOP-dominated Congress has already put plans in motion to make changes to the employer mandate, which has been so hotly contested since the enactment of the law.

One thing is certain though — the Affordable Care Act has provided people with the resources and incentives necessary to get coverage. As of March 2015, more than 16 million people were covered because of the federal and state exchanges, Medicaid expansion, and the provision allowing young adults to remain on their parents’ plan.

It’s the primary point Obama focused on in his speech, the difference the law has made in getting people the coverage they need.

“For folks who are basing their entire political agenda on repealing the law, you have got to explain how kicking millions of Americans off their insurance is somehow going to make us more free.”

Overall approval of the law among Americans is still split, but the gap between favorable and unfavorable opinions has narrowed to the closest margin in two years, with 43 percent opposed to the ACA and 41 percent in favor, according to the Henry J. Kaiser Family Foundation.

Approval among employers is still low, as in some cases it has required an increase in coverage or implementation in plan administration. Recently, in two separate House subcommittee meetings, employer and industry representatives testified about the effectiveness of the mandates as well as expressed real-world experience with the law.

Sally Roberts, director of human resources at Morris Communications Company, who testified on behalf of the Society for Human Resources Management said she now spends twice as much time administering benefits.

“The ACA has made benefits much more complicated than they were before,” she said to Employee Benefit News.

Related Post: Listen to Tom Quigley Talk About Obamacare on ClaimLinx Podcast

However, the law has not had quite the adverse effect on business or insurance plan rates that was once predicted. In fact, premium increases are significantly lower than they have been in the last 50 years.

Premiums for family policies in the group market grew by 72 percent between 1999 and 2004; 34 percent between 2004 and 2009; and 26 percent between 2009 and 2014.  But in 2014, premiums increased by only 3 percent, according to the Henry J. Kaiser Family Foundation.

It’s perhaps because of these victories that Obama remains optimistic about the progress and future of the law, despite all of the issues so far.

“We’ve made our share of mistakes since we passed this law. But we also know without a shred of a doubt that the policy has worked. Coverage is up. Cost growth is at a historic low. Deficits have been slashed. Lives have been saved”