Professor Robert Field said as a new contributor to a Harvard Law School blog that a D.C. Circuit Court ruling that bars some states from collecting federal subsidies to help low-income people buy health insurance appears to misinterpret the legislation that gave rise to the Affordable Care Act.
The court ruled on July 22 that states with federally-run health care exchanges are ineligible for subsidies to help low-income residents purchase health care, since the legislative wording specifies that funds would be available through an exchange "established by the state."
Field noted in the "Bill of Health" blog launched by Harvard Law School's Petrie Flom Center that the legislative language may reflect a distinction between health care exchanges operated by government entities and those run by private employers.
Observing that the legislative history of the complex bill does not clearly answer the question, Field added that Congress did clearly aim to make health insurance accessible to residents of all states when it enacted the law.
On July 23, Field said in an interview on WHYY that the D.C. Circuit ruling could “seriously gum up” Obamacare.
Another federal court in Virginia reached the opposite conclusion, ruling that Congress intended to make subsidies available to anyone who needs them, regardless of whether the state or federal government is running the exchange.
The two opposing views leave the fate of the Affordable Care Act in limbo.
“This will not be resolved until the Supreme Court finally hearts it, which is going to be at the earliest, next year,” Field said. “In the meantime, if I were a Pennsylvania recipient who was receiving a subsidy, I’d be at least a little bit worried that in the long term, that subsidy could go away.”
In a posting on “The Field Clinic” blog published by Philly.com, Field explained that the court in D.C. based its ruling on a narrow reading of the law, which says subsidies are available for policies purchases on an exchange “established by the state.”
Field argued that the ruling “makes no sense in light of Obamacare’s overall purpose. Subsidies are a crucial part of making health insurance widely available. Why would Congress bestow this benefit on Americans who live in some states but not in others?”