“This is definitive,” said Kathleen Sebelius, the former secretary of health and human services, at the Aspen Ideas Festival on Friday. Sebelius was referring to Thursday’s 6-3 decision by the U.S. Supreme Court in King v. Burwell. The justices ruled that the health-insurance subsidies provided by the Affordable Care Act should be available to people whether the states they live in use the federal health-insurance exchange or run their own exchanges.
The decision hinged on four words in the ACA statute: “established by the state.” The plaintiffs contended that these words meant subsidies should only be available to those on state-run exchanges, not federal. But in the decision, Chief Justice John Roberts wrote, “We doubt that is what Congress meant to do.”
“What was at stake was 34 states, 6.4 million people who have subsidized insurance policies,” Sebelius said at the panel. “If the court had ruled for the plaintiffs, they would be subject to losing the subsidies that made their insurance affordable and thus lose their insurance. Roberts … basically said, you need to look at what Congress intended. Congress intended to help fix the insurance market, not destroy the insurance market.”