Democratic Congresswoman Kathy Castor (D-Tampa) attended the U.S. Supreme Court's oral arguments Wednesday in the case that, if decided in favor of the plaintiff, would strike down federal health insurance tax credits in states that did not establish their own health exchanges.
Castor, a strong supporter of the Affordable Care Act, was in Congress when the bill was being drafted and debated. She says the court could go either way, but believes the majority of justices are supportive of keeping the law intact.
"My impression is that the tax credits for Floridians will survive," Castor said during a conference call Wednesday afternoon. "I counted four distinct votes [for] reading the Affordable Care Act in its total context, to say of course if you're in one state versus another your tax credit treatment should not be different. I would probably put a couple of justices in the camp of… cherry-picking that one phrase they're hanging their hat on, and I'd count two justices that I'm uncertain about."
There's extensive speculation about the decision (even a Fantasy SCOTUS page predicting the case's outcome), which is expected to be handed down in June.
The suit, King v. Burwell, hinges on perceived ambiguity in the section of the law having to do with setup of state healthcare exchanges, and the tax credits offered to those who use the exchanges. The plaintiffs' argument is based essentially on a few words in the ACA — "that one phrase they're hanging their hat on," in Castor's words — that seem to indicate that those who buy health insurance through an exchange set up by the federal government (rather than a state) are not eligible for federal tax credits.
Castor — who was in the room when the law's finer points were being discussed — called bullshit.
"I can tell you I understand the legislative intent and statutory construction as well. It is clear that, being a member of one of the committees who heard all of the hearings, participated in the markup and drafting of the Affordable Care Act, there was never any discussion about disparate treatment between a state-facilitated exchange and a federally-started state exchange and tax credits," she said. "There was never any dichotomy intended. The Affordable Care Act was always structured and designed to provide those tax credits to all citizens all across the country no matter what kind of exchange they shopped and got their health insurance in."
Castor said she's concerned about what would happen to the rest of the act if the justices rule in favor of the plaintiff.
"If they take the thread and begin to pull it out of the sweater of the Affordable Care Act by canceling tax credits in states with federal exchanges, it will begin to unravel the Affordable Care Act. Unfortunately, that's what a lot of the partisans intend," she said. "This case really is a partisan, ideological attempt to undermine the foundation of the Affordable Care Act and it is not based in sound law."
Also on the call were a few of Castor's constituents who benefit from the tax credits they receive for purchasing policies through Florida's exchange, which was set up by the feds.
Nicole Peterson, a single mother who got divorced in the past year, was one of these. She said she was was able to get a plan for herself and her three daughters. Her monthly premium was $468, and she receives a credit of $150.
"It's phenomenal for our family situation," she said. "It enables me to not only be able to afford the policy, but also it helps me to stay healthy. It helps me to not have that fear of any time I'm sick: okay, do I go to the doctor, or do I buy groceries this week?"
This article appears in Feb 26 – Mar 4, 2015.