CHARLESTON, W.Va. – Subsidies for West Virginians who purchased health insurance through the federal exchange will continue without interruption for the immediate future at least, according to federal and state officials.
That’s because appeals are expected on two opposing court opinions — both released Tuesday — on the federal subsidies that are a major part of the Affordable Care Act.
“My instinct is the Obama Administration will appeal to the broader panel, so they’ll have seven people look through this where they have a more favorable political group looking at the case,” said Patrick Morrisey, state attorney general.
“Ultimately, if there is a split in the circuits, this case will go all the way up to the U.S. Supreme Court.”
On Tuesday, the U.S. Court of Appeals in the District of Columbia ruled the Affordable Care Act only allows for subsidies for coverage in states that run their own insurance marketplaces. The 36 states, including West Virginia, that use the federal exchange instead of their own systems, do not qualify for subsidies, the Court of Appeals said.
“Section 36B (of the Affordable Care Act) plainly makes subsidies available only on exchanges established by states,” wrote Judge Thomas Griffith in the 2-1 decision that he said was reached “with reluctance.”
“Here, the language is really clear,” Morrisey said on Wednesday’s MetroNews “Talkline” of that ruling. “I think that the Court looked and, while everyone was trying to ascertain Congressional intent and figure out what everyone meant, they read the plain language of the Act which was clear.”
A short time later on Tuesday, though, the U.S. Court of Appeals for the 4th Circuit in Richmond, Va. issued a contradictory ruling that upheld the subsidies for insurance coverage through state marketplaces along with the federal exchange at Healthcare.gov.
The language of the Affordable Care Act on this point is “ambiguous and subject to multiple interpretations,” the Fourth Circuit said in a unanimous decision.
“Two decisions on the exact same day, I’m not sure the last time that that happened,” said Morrisey of the timing of the rulings.
As of earlier this year, about 5.4 million people had signed up for health insurance on the federal exchange and 87 percent of those people received subsidies for that coverage. The Congressional Budget Office has estimated the average subsidy this year will total about $4,410.
Without such subsidies, more people would not be able to afford health insurance and, because of that, would be exempted from the individual mandate that requires insurance coverage.
Penalties for the employer mandate on the Affordable Care Act are based on the availability of subsidies.