"An Exchange Established by the State"
Suppose I say to you, "Last year, I put a big addition on my house." Since I'm not a professional builder, the odds are you will assume that what I mean is that I hired a contractor and/or a team of masons, carpenters, electricians, plumbers, etc., who physically built the new structure. You are not likely to immediately picture me single-handedly raising roof trusses. Neither are you going to take me for a liar who claimed she did a big job when in fact she didn't lift a finger. You know what "put" means, but you didn't limit your understanding of it to its most narrow, literal meaning.
So what is "an exchange established by the state"? After all, the entire question raised by the plaintiffs in King v. Burwell is a semantic one.
News reports about the number of people who would lose health insurance if the Supremes side with the King v. Burwell plaintiffs typically cite 37 states as not having "an exchange established by the state." Here's a Kaiser Foundation map of state "subsidies at risk" in the King case (the linked map is interactive):
But that is not really true. It turns out that 19 states have established (there's that word again) some manner of "state-federal partnership" exchanges, according to this Commonwealth Fund interactive map (the linked map is interactive):
That's in addition to the 13 states which independently run their exchanges and are not subjects of the lawsuit. So that is 32 states which actively run all or part of their health insurance exchanges. That means only 18, not 37, states have not actively established exchanges.
Surely a state that is running its exchange in partnership with the federal government is operating "an exchange established by the state" -- just as "I put an addition on my house" in partnership with my contractor & her subs.
Will it take another lawsuit to determine what the meaning of "established" is? It shouldn't
The plaintiffs in King have claimed a tortuously narrow meaning of "established by the state." But anyone conversant with English, even reading that clause alone & not in the context of the entire law, would understand a more flexible meaning of "established." A reasonable person would assume that a state government that was working in partnership with the federal government had "established" -- that is, recognized, accepted & embraced -- the exchange operating in that state. Even Justice Moops (né Scalia) should be happy with this. He is fond of using the dictionary as a source for some of his arguments. Therein he will find "recognized" as a synonym for "established," as in "established church."
Thus, there is a way for the justices to decide for the plaintiffs but still allow residents of states with federally-run exchanges to get their health insurance tax credits/subsidies. The 32 states which are currently participating in managing or outright running their exchanges already have exchanges "established by the state."
The Court can then allow other states, via legislative or executive resolution, to declare that the exchange the federal government set up for their state has been "established by the state." That is, it is a bona fide, state-sanctioned system.
It is true that such a decision might leave out a few Republican-run states where residents are currently receiving subsidies. But I expect public pressure would cause them to recognize the federal exchanges as their own.
So if the states-rights justices insist upon being all federalisty, they can let the states decide if they want to "own" the federally-run exchanges, save their residents millions of dollars and ensure that tens of thousands can purchase affordable health insurance. It will only take one election cycle to get rid of the lamebrains who don't.
Reader Comments (4)
@Marie: You make an interesting argument, with logic and clarity. Let's hope the briefs submitted on behalf of defendants rise to your level! On the other hand, it does make me curious as to whether your contention that State run plans can be deemed to exist in more than 13 states was raised by the Government - or in any of the Amicus briefs.
I tried to research this and have come up empty. I did unwittingly read a number of commentaries by right-wing bloggers. Very depressing.
Agree 100% that state has more than one meaning. Like, a state visit
by Netanyahoo doesn't mean he's going to Indiana. He's visiting a
nation, the United States of America. We normally would say
Secretary of State and mean of the USA, otherwise we would prefix
it with Michigan or suffix it with of Michigan and to me if I read
State Department, I think of DC, not Ohio. But that's just my thoughts. I'm not a lawyer or constitutional scholar.
@Victoria D.: I think the government rightly wanted the fallout from a King plaintiffs' victory to look as terrible as possible. I don't think it would have been in the public interest to suggest the outcome of a successful suit would be no big deal.
I still of course hope that the plaintiffs lose, & one of the Ladies of the Court gets to write the opinion excoriating the plaintiffs for being nasty, ignorant dupes of a cruel, ideological cabal. (Of course it won't happen that way; if the government wins, more than likely the opinion-writer will be Kennedy or Roberts, & the dissent will be well-wrought, aggrieved nonsense.)
I think a likely -- and sensible -- outcome would be a "compromise," one to which all of the justices sign on, which might require every state to affirmatively embrace the federally-built and -run exchanges as their own.
Crippling the ACA on this flimsy thread of whimsy would be just plain stupid -- and as Linda Greenhouse suggested -- the end of the Court's stature as an instrument of justice. I am counting on Roberts & Kennedy to be smart enough to see that thru the peepholes in their GOP-colored crazy glasses.
Marie
Marie,
Those glasses are a deep, deep red, and to say it's a matter of semantics is technically correct but truly we're not talking about a matter of recondite legalisms or lexical befuddlement. What we have here is a case of 4th grade reading comprehension. It's like trying to argue that the boy who cried wolf was simply calling for a friend named Wolf, which is a reasonable assumption if you just forget the rest of the story.
Should Scalia and Roberts (forget Alito and Thomas, those fuckers are secret handshake, card carrying partisans and allow not the tiniest inkling of actual justice to impeach their lurid tribal inclinations) slit the ACA's throat based on ignoring the ideologically inconvenient context of a thousand pages, they will be no different than cheap carny card sharps. It would make them no better than judges and city officials in Ferguson who use the perverted and subjectively applied ultra narrow letter of the law to line their pockets while flushing justice down the hopper.
First, this sad sack challenge should never have made the cut. Never. One of the plaintiffs was accorded standing based on having stayed for two weeks at a motel! So because she was in this neighborhood for a cup of coffee, she now has the sort of standing that allows her to bring her case to the Supreme fucking Court??? The other losers are not much better in terms of standing.
Just imagine the gales of laughter and snark from Scalia and Alito and Thomas (if he was conscious), and even Roberts, should a challenge to Alabama's stoppage in the issuance of same sex marriage licenses be brought by someone whose cousin once knew a same sex couple, and who was pretty sure he had run into a gay couple at a New Year's Eve party once, a few years ago.
Even so, this is the sort of case of which Scalia, especially, would be contemptuous, based as it is on the willfully perverse misreading of four words out of context. It's too stupid even for an SNL skit!
But to use this perverse misreading as a dime store Blackstone magic trick to clothesline millions of Americans because you just couldn't abide a lukewarm reception the next time you speak before Federalist Society douchebags, would depend upon the sort of quisling casuistry that Dante required of characters bound for the ninth ring.
And make no mistake. If they do find for the plaintiffs, they do it in full knowledge that theirs is a tainted and sordid decision, based as it would be on partisan chicanery and shameful, shameful sophistry.
Will that deter them?
I hope Lewis Powell, wherever he is, is thrilled.
P.S. And don't overlook one exceedingly important plot point in this storyline. If wingnut tribalism on the court has finally gotten to the point where cases of no more substance than "I know you are but what am I?" can make it to the court--and possibly win--just think of the giddy, bug-eyed lunacy this will open up. Get ready for challenges to everything the Bedlam 'baggers despise. They have a ready audience in the highest court in the land.
In my dreams, here's what I wish for: (substitute Scalia for asshat professor and Thomas Jefferson for Marshall McLuhan).