Two hours after the US Court of Appeals for the District of Columbia ruled in a split decision that provisions of the Affordable Care Act providing tax incentives for low-income citizens to purchase health insurance were unconstitutional, the US Court of Appeals for the Fourth Circuit unanimously upheld the provisions.
The appeal claimed that very specific language written into the ACA, also known as Obamacare, conflict with the authority of the Internal Revenue Service regarding tax credits to would-be insureds and penalties for those who opt out in states that have not set up their own exchanges. In King v. Burwell court paperwork, three judges wrote that the IRS interpretation of the law is not contrary to the language in which the law is written.
“The plaintiffs in this case are Virginia residents who do not want to purchase comprehensive health insurance,” the judges wrote. “…Without the premium tax credits, the plaintiffs would be exempt from the individual mandate under the unaffordability exemption. With the credits, however, the reduced costs of the policies available to the plaintiffs subject them to the minimum coverage penalty.”
They described the arguments made by the plaintiffs as “not persuasive” and “based on an incorrect premise,” but acknowledged that some of the language in the act is “ambiguous.”
Senior Circuit Judge Mark S. Davis wrote in a concurring statement, “Congress specified that exchanges should be established and run by the states, but the contingency provision permits federal officials to act in place of the state when it fails to establish an exchange.”
The American Cancer Society, American Cancer Society Cancer Action Network, American
Diabetes Association and American Heart Association filed an amici brief in each of the cases, as well as in others that are pending.
In a joint statement following the decision, the groups wrote, “After the disappointing decision from the US Court of Appeals for the D.C. Circuit this morning, we are especially pleased with the decision of the US Court of Appeals for the 4th Circuit, which ensures that people who buy a health plan in either the federally facilitated marketplace or a state-run marketplace can benefit from premium tax credits that help to make the coverage more affordable. … We hope that additional legal review of this question will be consistent with the 4th Circuit decision and ensure that millions of people with serious chronic diseases can access lifesaving care.”
After the earlier decision from the D.C. court, the groups wrote, “Being uninsured can have disastrous consequences for people with chronic diseases. Numerous studies have shown that people without health insurance are less likely to receive screenings and other services that can prevent disease or detect dangerous conditions early, and are more likely to delay treatment.”