Editor’s Desk

King’s Attorney Tells Managed Care How It Would Have Been If He’d Won

Frank Diamond
Managing Editor

What many health plans like about the Affordable Care Act is that it’s going to expand the marketplace, handing insurers millions of new enrollees. The Supreme Court’s ruling today against King in King v. Burwell ensures that that should still be the case. Of course, the law is sometimes a “a river that don’t know where it’s flowing,” in the words of Bruce Springsteen. Today’s decision offers a bit of stability.

Michael A. Carvin, the lead attorney for plaintiff David King, told Managed Care a few weeks ago that had King won, health plans would be scrambling. A King victory would have meant that in 34 states, there wouldn’t “be any subsidies for people buying insurance off the exchanges” complicating the projections insurers “made in terms of the amount of paying customers they are going to have.”

King, a limo driver and Vietnam veteran, didn’t want to buy health insurance, but because of the ACA mandate to cover everyone, he argued he was forced to do so. He lives in Virginia, one of 34 states that didn’t create their own health care exchanges, which means residents have to purchase coverage on the federal exchange. King argued that the ACA specifically states that subsidies are provided for those purchasing coverage on exchanges “established by the state.”

“Technically, it’s government lawlessness,” Carvin told Managed Care. “The Obama administration wanted a particular policy on subsidies which was contrary to the plain text of the law that was enacted. But they nonetheless went ahead and imposed their own policy views instead of the law that was properly enacted.”

The Supreme Court doesn’t see it that way.

While today’s ruling is a victory for President Obama, Republican might have dodged a bullet as well. As Managed Care reported, Republicans could have well been blamed if millions of Americans had lost their subsidies and, therefore, their coverage.