Here are the words from a document initially more than 900-pages long that conservatives here seized on to make a case to stop low-income people from getting health insurance:
“Exchange established by the State . . .”
The U.S. Supreme Court upheld the 2010 Affordable Care Act Thursday in a 6 to 3 ruling that had driven some local conservatives, such as The Oklahoman editorial board and U.S. Sen. James Lankford to make some of the most tortuous arguments ever used or given credence in the public arena. In the end, now that the ruling has come down, it all seems so absurd.
Why are we just now debating the five words in a law passed five years ago? It’s because conservatives are trying to find anything they can to deny people health insurance.
The ruling clarifies that subsidies for health insurance can be given to qualifying low-income people on the insurance exchanges maintained by the federal government for those states that chose not to established their own state-operated exchange. That was always the intent of the law, which is clarified throughout its initial pages and subsequent regulations, including an Internal Revenue Service ruling.
The law was always meant to be a national law, not one designed for only particular states that opted in on the law. The idea that the five words I quoted above prove otherwise is cherry picking at its worst. The fact so much money and time has gone into addressing the argument seems to me incredibly wasteful and ridiculous, and the 6-3 ruling in a normally 5-4 divided court shows the case had little to no merit.
Chief Justice John Roberts, who wrote the majority opinion, said it this way: “Congress 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.”
Let me parse that even further. Is there any doubt that the law was conceptualized to help get as many people as possible health insurance? Those arguing that “the State” was an intentional limitation are incredibly wrong or being deliberately deceptive. I choose the latter. Those that argue the five words render the entire debate, Congressional vote, more debate and legal wrangling over the law meaningless and void, including all the subsequent regulations, are just trying to manipulate or find a loophole. It’s simple dishonest politicking.
Here’s how The Oklahoman editorial board disingenuously lamented the ruling:
If the plain meaning of a law can be ignored and unilaterally revised, based on the whims of presidential administrations or judges overly concerned with political considerations, then the law provides neither definitive citizen protection nor regulatory clarity.
But those five words have to be read in a context. Anyone can pick out five words in an incredibly long document and distort them. What about typos or word omissions or, perhaps in this case, a confusing phrase? All these rhetorical issues can be reconciled. It’s a question of a simple fix in language.
As Roberts wrote, “Contrary to petitioners’ argument, Congress did not believe it was offering states a deal they would not refuse – it expressly addressed what would happen if a state did refuse the deal.” That’s exactly right. It’s clear in the law, was made clear in Congress and was made clear by the subsequent IRS ruling. The federal government would run the exchange for states that “did refuse the deal.” How difficult is that to understand?
Oklahoma, of course, is one of 37 states that “did refuse the deal,” including not accepting additional Medicaid money from the federal government.
U.S. Sen. James Lankford, who confidently predicted in a Senate speech that the high court would not allow subsidies in states without a state-operated exchange, said before the ruling, “I believe they’re going to rule on the plain text of the law. Does the law mean what the law says? Or can the administration reinterpret it based on their preferences?” Again, cherry picking five words from a longer document doesn’t constitute “the plain text of the law,” and this wasn’t the administration reinterpreting anything. How many times must this be said before conservatives get it: The intent of the law was to provide access to health insurance and subsidies to uninsured people in ALL the states. This is not a reinterpretation. Lankford is as wrong as his wise and bold prediction in his Senate speech.
Then there’s Oklahoma Attorney General Scott Pruitt, who has sued the federal government over this one law four times. Let me cherry pick his statement, which you can find in its entirety here, in response to the ruling. Pruitt argues, “There’s no doubt the rule of law took a hit today, but I won’t be deterred from continuing to fight for the rule of law and our founding principles.”
What in the world do “our founding principles,” always subject to an incredible amount of debate in the first place, have to do with five cherry picked words? Pruitt’s and Lankford’s rhetoric show their intentions are political rather than legal. I understand they’re politicians.
I wasn’t a big fan of the ACA when it was signed into law in 2010 because I wanted a universal public insurance option, but I did see it and still do as a first step towards that goal. Health care should be a human right. It establishes our basic humanity. Let’s debate that point in Congress, courts, schools and in our homes, but let’s quit wasting time on “frivolous lawsuits,” a term I bet is used more often by conservatives than progressives. The ACA is five years old now. It’s working. It can be improved. Local conservatives here, especially Pruitt, need to let it go.