You know what they say about opinions, everyone has one, but let's not be completely stupid and remember there are some facts involved.
Who does King v. Burwell potentially impact?
Individuals enrolled in Obamacare in states that did not establish an exchange (most states) who have been getting money from the federal government to help pay for their premiums. It does NOT affect individuals who do not get health insurance through an exchange. It does NOT affect people on Medicaid or expanded Medicaid.
Why is the government arguing that it WANTS TO PAY money towards people’s premiums?
The government wants people enrolled in Obamacare who are paying for their premiums and getting help from the government (which is 87 percent of the enrollees) to theoretically keep enrollment high enough so that there’s a spread of people healthy, unhealthy, et cetera purchasing health insurance through exchanges. Since enrollment has been consistently lower than anticipated (according to the Congressional Budget Office), the government WANTS to pay for premium assistance to keep more people enrolled.
What does the law say?
The Affordable Care Act in section 1401 that incorporates 36B of the Internal Revenue Code states that to be eligible to receive premium assistance individuals must have gotten health insurance by being “…enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act.” (Use Google’s published version of the PPACA it’s way easier to navigate). The government is arguing against itself that the law it passed is not what it meant.
What is the difference between a state exchange and the Federal Exchange we’re hearing about?
There is NO SUCH THING AS A FEDERAL EXCHANGE in the Affordable Care Act which was supposed to respect states rights. The Federal government’s role was one of oversight and assistance in states implementing exchanges. There is no mention of even a federally facilitated exchange.
What is mentioned in section 1321, under the heading “FAILURE TO ESTABLISH EXCHANGE OR IMPLEMENT REQUIREMENTS” is a provision that the Secretary of HHS IF a state fails to establish or implement will “establish and operate such Exchange within the State,” that’s why they were at first called Federally FACILITATED exchanges, because there is NO provision for a Federal Exchange.
What is there provision for in the law if not a Federal Exchange?
A Federal PORTAL. Under section 1311, in its oversight capacity, the Federal government is supposed to “…continue to operate, maintain, and update the Internet portal developed under section 1103 (a) and to assist States in developing and maintaining their own such portal; and (B) make available for use by Exchanges a model template for an Internet portal…
What is the issue for the people named in King v. Burwell? Why would people NOT want federal government money to help pay for their premiums?
The issue is that they were trying to get around the individual mandate that makes people purchase health insurance or pay a tax by claiming that they would have qualified for the hardship exemption to that tax based on their incomes except that with the money paid by the federal government in premium assistance which lowered their health insurance expense and made it so that they are required to purchase health insurance or pay a tax.
