Dueling Rulings: What the Conflicting Circuit Court Decisions on ACA Subsidies REALLY Mean.

Two Federal court rulings on one day have helped add to the already chaotic atmosphere surrounding the ACA implementation. Potentially affected are millions of lower and middle income Americans living in 34 states which utilize the federally run insurance exchanges. Three judges of the 4th U.S. Circuit Court of Appeals ruled unanimously in favor of allowing the IRS to offer promised subsidies, while a three judge panel of the U.S. Court of Appeals for the District of Columbia Circuit, in a split decision, ruled they could not. The case is likely headed to the U.S. Supreme Court, but that decision could be a year or more away. Meanwhile, what's a country to do?

It would be wonderful if Congress would see the problem caused by less than crystal clear wording in one or two paragraphs contained within the almost 1,000 pages of the law. In the current political climate, that's a long shot at best. The best chance is for an administrative fix. Not much of a problem where the state government wants the program to succeed. In states such as Florida, which have been hostile towards ObamaCare, things can get a lot more dicey. Expect a lot of finger pointing and posturing.  

So in the end, what do the conflicting rulings really mean? The Obama administration is expected to appeal the DC ruling to the full court, which could stop the challenge immediately. On a broader scale, the result will most likely cause even more confusion among the American people, further drops in already dismal government approval ratings and lots of legal fees generated. That's it. The ACA is law, people are getting covered, and there is no way that any branch of our government is going to take that away. 


Steve Weinman is a Vice President at FQHC Germane, a health care consulting firm specializing in the needs of established, new and potential Federally Qualified Health Centers (FQHCs).

Read more about Steve here.

To contact Steve, email him at sdweinman@fqhc.org.