The opponents of the Affordable Care Act have filed another long-shot lawsuit that could undermine health care reform and force many consumers to pay more for health insurance if the suit succeeds.
The Supreme Court has already agreed to hear a separate case, filed by anti-reform forces, that seeks to prevent the payment of tax credit subsidies to help people buy insurance in 36 states where the federal government has established health care exchanges because the state chose not to. If that case succeeds, low- and middle-income people in those states will have to pay a lot more of their insurance premiums.
The new suit, filed late last month by the Republican-dominated House, aims to block another important subsidy: federal payments to insurance companies to keep deductibles, co-payments and other cost-sharing low for the poor. The Affordable Care Act specifies the maximum amounts people will have to pay in cost-sharing based on their incomes, and federal subsidies make up the rest.
If the government is blocked from reimbursing insurers for the subsidies, the insurers will have to absorb the costs. But companies might well raise their premiums for everyone else in the individual market to recoup the loss. The House lawsuit argues that no money was appropriated to reimburse insurers for cost-sharing and that the administration could not use money from a separate account that subsidizes premiums.
The Affordable Care Act authorized these cost-sharing subsidies when it was enacted in 2010 and the administration at one point requested an appropriation, but Congress failed to provide it. The House suit argues that it was unconstitutional for the administration to tap the separate fund to pay cost-sharing subsidies that are expected to total $175 billion over a 10-year period.
For the suit to proceed, the House must show that it has standing to challenge the administration’s action. Courts often shy away from disputes between Congress and the executive branch. This suit does not even reflect the will of Congress, since it was filed only by the House, not the whole Congress.
The House will have to prove that it was injured by the administration’s action and that the injury can be best fixed by the courts rather than by political means. If the courts grant standing, the House will have the additional burden of proving that a specific appropriation for this subsidy is actually required. If the House Republicans prevail and no law appropriating money is enacted, the harm may be significant. Many, if not most, of the people enrolled in health plans on the exchanges are believed to receive cost-sharing subsidies from insurers. If the federal government cannot assist, a lot of other individual policyholders may have to pay more.
Friday, December 12, 2014
U.S. - Another Baseless Attack on Health Law
The opponents of the Affordable Care Act have filed another long-shot lawsuit that could undermine health care reform and force many consumers to pay more for health insurance if the suit succeeds.
The Supreme Court has already agreed to hear a separate case, filed by anti-reform forces, that seeks to prevent the payment of tax credit subsidies to help people buy insurance in 36 states where the federal government has established health care exchanges because the state chose not to. If that case succeeds, low- and middle-income people in those states will have to pay a lot more of their insurance premiums.
The new suit, filed late last month by the Republican-dominated House, aims to block another important subsidy: federal payments to insurance companies to keep deductibles, co-payments and other cost-sharing low for the poor. The Affordable Care Act specifies the maximum amounts people will have to pay in cost-sharing based on their incomes, and federal subsidies make up the rest.
If the government is blocked from reimbursing insurers for the subsidies, the insurers will have to absorb the costs. But companies might well raise their premiums for everyone else in the individual market to recoup the loss. The House lawsuit argues that no money was appropriated to reimburse insurers for cost-sharing and that the administration could not use money from a separate account that subsidizes premiums.
The Affordable Care Act authorized these cost-sharing subsidies when it was enacted in 2010 and the administration at one point requested an appropriation, but Congress failed to provide it. The House suit argues that it was unconstitutional for the administration to tap the separate fund to pay cost-sharing subsidies that are expected to total $175 billion over a 10-year period.
For the suit to proceed, the House must show that it has standing to challenge the administration’s action. Courts often shy away from disputes between Congress and the executive branch. This suit does not even reflect the will of Congress, since it was filed only by the House, not the whole Congress.
The House will have to prove that it was injured by the administration’s action and that the injury can be best fixed by the courts rather than by political means. If the courts grant standing, the House will have the additional burden of proving that a specific appropriation for this subsidy is actually required. If the House Republicans prevail and no law appropriating money is enacted, the harm may be significant. Many, if not most, of the people enrolled in health plans on the exchanges are believed to receive cost-sharing subsidies from insurers. If the federal government cannot assist, a lot of other individual policyholders may have to pay more.
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