Public Woefully Uninformed about King Case


By Hadley Heath

A new Kaiser Health Tracking poll shows that 56 percent of Americans say they've heard nothing about the upcoming Supreme Court case King v. Burwell. Only 5 percent of people say they've heard "a lot" about the case.

If you are in the 86 percent of people who've heard nothing or "only a little" about King v. Burwell, here's a summary:

The Affordable Care Act required that states establish a health insurance "exchange" or default to a federally-operated exchange. Initially, the expectation was that most states would comply and create and maintain their own exchanges. But 37 states declined to establish an exchange. Some states did so because they are philosophically opposed to ObamaCare; others did so because wading through the cost and bureaucracy of creating an exchange was too much for them.  

The IRS was faced with a problem: The law described the state-based exchanges and the federal exchange in two separate sections (Section 1311 and Section 1321).  It never authorized subsidies to flow through the federal exchange. In an effort to fix this, the IRS decided -- even in the absence of Congressional authorization -- to push the subsidies through the federal exchange anyway.

The question before the Supreme Court in King v. Burwell is whether the IRS acted illegally.  Advocates of ObamaCare say the difference in the exchanges was just a drafting error, and that the IRS was acting in the spirit of the law to send subsidies through the federal exchange. Challengers say that no, the original Congressional intent was to bully states into establishing an exchange by withholding the subsidies from non-establishing states. Furthermore, they point out that allowing an administrative agency to go rogue and act without Congressional authorization sets a bad precedent and defies the rule of law. 

If the Court rules against ObamaCare in this case, the result could be that subsidies stop flowing to insurance companies in the exchanges of the 37 non-establishing states. As the Kaiser polling points out, the majority of people (64 percent) say that in the event of a King victory, Congress should act. Already, Republicans in Congress have formed a working group to prepare a policy with a responsible transition for the affected exchange consumers and options for states to restore competitive markets and affordablity to their health care systems.

Oral arguments for the King case are set for March 4, 2015. 


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