One word sums up the Supreme Court’s ruling in King v. Burwell—“Enough!”
The first lawsuit seeking to strike down the Affordable Care Act (ACA) came just seven minutes after the President signed the bill on March 23, 2010. The assaults continued even after the Supreme Court upheld the law as constitutional. For all but those first seven minutes, the ACA has weathered nonstop legal attack, as its opponents sought to enlist judges to undo their political defeats in Congress.
To that end, an American Enterprise Institute Conference in late 2010 foraged through the 900 pages of the ACA in search of some plausible flaw to eviscerate the statute “as a matter of political hygiene.” All the quest turned up was an awkward phrase in what the Court in Kingcalled the “ultimate ancillary provision: a sub-sub-sub section of the Tax Code.”King v. Burwell, 25 No. 14-114 (U.S. Jun 25, 2015), at *25. This previously undiscovered provision supposedly barred subsidies that help low-income families afford insurance if their States opted to have the Federal Government establish insurance Exchanges rather than doing it themselves. Congress, in other words, deliberately embedded a self-destruct mechanism deep in the statute.
Before jumping to the four-word phrase at issue, it is not only useful but necessary to examine its context—the history, purpose, and structure of the ACA, as the Court did in King. Congress enacted the ACA to reduce the number of people without health insurance. The law barred insurers from refusing to cover consumers because of their preexisting illnesses, but counterbalanced that prohibition with a requirement that virtually everyone maintain insurance coverage. To make that requirement affordable, the ACA directed each state to establish a marketplace, called an Exchange, that would function like Travelocity, affording individual consumers the knowledge and leverage to negotiate insurance contracts as favorable as those offered to purchasers of large group policies. To ensure that these Exchanges functioned everywhere, the Act instructed the Secretary of HHS to step in and establish “such Exchange” if the State did not do so itself. As a further step to make insurance affordable, the ACA also lowered the net cost by providing tax subsidies, based on income, for those purchasing policies on an Exchange.
The “discovery” announced at the AEI conference in November 2010 was that the formula for calculating the amount of the tax subsidy was keyed to the price of insurance sold on an “Exchange established by the State.” Because an Exchange established by the HHS Secretary is not an “Exchange established by the State,” the argument ran, no policies in States with a Federal Exchange fell within this category, and the amount of the subsidy in those States was zero. In the view of the ACA opponents, the absence of any evidence that Congress intended this result, and the surfeit of evidence that it did not, were of no consequence. The courts, they argued, could look no farther than those specific words in the statutory language. Those words, “established by the State,” were purportedly so definitive as to preclude further inquiry.
In context, and as the ACA defined the relevant terms, the disputed phrase was not so definitive. Moreover, attributing such a statutory death wish to Congress defied common sense. But the argument had partisan appeal, a quality that, in the lower courts, seemed to predict outcomes fairly well. The Supreme Court, however, refused to treat litigation as an extension of partisan debates or to make the courts a preferred forum for redeeming legislative defeats. Rather, the Court lectured the ACA opponents, “In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined—‘to say what the law is.’” King, at *26 (quoting Marbury v. Madison, 1 Cranch 137, 177 (1803)). Therefore, “in every case we must respect the role of the Legislature, and take care not to undo what it has done.” Id.
Nor did the Court heed the call to blind itself to the obvious, to purge from statutory construction any resort to the evident statutory purpose.[1] Congress, the Court said, “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.” King, at *26. The overpowering simplicity and common sense of this proposition illuminate the sophistry behind the claims in King. They also indicate the power of ideology to subvert good legal judgment.
In sum, to the assaults on the ACA, to the attempts to re-litigate legislative defeats, to the propagation of partisan lawsuits, the Court said, “Enough.” The only remaining question is whether the ACA opponents will get the message.
[1] Even Justice Scalia, in a more neutral setting, has acknowledged that “(1) interpretation always depends on context, (2) context always includes evident purpose, and (3) evident purpose always includes effectiveness.” Antonin Scalia & Bryan Garner, Reading Law: The Interpretation of Legal Texts 63 (2012).