If you are a regular reader, you know that I have been following the Affordable Care Act for the last several years. My goal has always been to try to help music therapists and other related professionals figure out what the law actually might mean for access to music therapy and whether or not it will help or hurt our profession on the whole.
This is obviously a huge task! And not without peril! Over the last few years I have found that many people are reluctant to engage in the conversation simply because there are so many strong opinions on both sides of the issue. I have tried to to be very even-handed in my treatment of the topics discussed here on Music Makes Sense, and generally have kept things focused on the impacts the law may have for music therapy. I believe I have been pretty successful so far and I appreciate the dialogues that have been opened up about the topic within my professional field.
So let me break down the latest ruling for you:
Many people have been waiting on the Supreme Court decision King vs. Burwell that was handed down this morning. This case basically asked the question, "Do words matter?"
... and the justices have answered the question, "No!" The Affordable Care Act specifically stated that federal subsidies for low income participants to help them pay for premiums purchased through the Health Care Exchanges could only be provided through exchanges "established by the States." This was intentionally written into the original law as a way to encourage individual states to set up their own marketplace exchanges. As it turned out, 27 states decided not to develop their own exchanges. The federal government decided to step in and created Healthcare.gov for participants in those states to use. In King vs. Burwell, states sued the federal government because the law did not say that people in these states should be able to receive subsidies.
Now, whether you oppose or support the law, you can see the conundrum here. If the Court ruled that the law meant what it said (and what Congress had intended), there would be a lot of people who have been receiving subsidies for almost two years, who would lose their subsidies and be unable to pay for their premiums. These same people would then suffer a tax penalty for not having insurance. What a mess!
(...I could digress here and point out that perhaps it is a good idea to write laws clearly, in a bi-partisan manner, and allow public review before voting on it...but, we'll leave that for a different blogger!)
But alas, we have been "saved" by SCOTUS! The 6-3 ruling today explained that although the law was badly written, it was meant to help people. Therefore, the court ruled that it will be okay for subsidies to extend to people signed up under the federal exchanges. Basically, six unelected and unaccountable (except maybe to history) individuals have written a new law that applies to every citizen.