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.

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Comments

  • Aaron

    Let us do the math on these subsidies.

    "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"

    That means 4.7 million Americans get their health care subsidized.

    "e Congressional Budget Office has estimated the average subsidy this year will total about $4,410."

    By those calculations, health care this year will cost taxpayers about $21,000,000,000.00 (that's BILLION for the zero impaired) to cover 1/10th of those who had no insurance when the (non) Affordable Health Care Act was passed by Democrats.

    So what happens when the number of enrollees double or triple and not enough young people are signing up? How soon until the cost hits $100 Billion? $200 Billion? $1 Trillion?

    That kind of disputes the notion that this Health Care Act is AFFORDABLE. And to think, supporters actually said it would REDUCE our national debt.

    Can I get a Yeesh???

    • Jephre

      Yeesh!!!
      If it does go to the Supreme Court, I hope they do a better job this time than in 2012, because they really botched that one.

  • Debra

    I believe the administration will appeal to the full DC court. There they will get the ruling that they wish for and there will be no disagreement between the two circuits. Therefore, I don't think the Supreme Court will even see this case. I think it is fairly clear that Congress intended for most individuals to have insurance and that is how the discrepancy will be remedied.

    • The bookman

      You mean you hope SCOTUS doesn't see this case. They have already demonstrated their distaste over this President's abuse of executive authority this session. It is a shame that the Federal Courts do not consider the rule of law, and future rulings are predicated on vote counting instead of what is clearly an affront to Congress.

      • Debra

        In the case of Chevron the Department of natural resources Defense Council, the Supreme Court ruled that deference must be given to the executive agency. That would be DHHS. They also ruled that the intent Congress and the law were to be used. In this case Congress intended for as many people as possible to get insurance. I will meet you back here when the Supreme Court doesn't even take this case.

        • The bookman

          So the intent of the law was to cover as many people as possible, and therefore it's ok to disregard the clear language of the law. Well I guess that's good enough for me.

          • The bookman

            But the language is clear. It specifically states that subsidies may only be applied when the applicant uses a state exchange, not federal. So politically, you hope the full DC circuit rules against the specific language in the law and in favor of the President's position. Thanks for your time.

          • Debra

            I'm just saying that the court says that when the language is unclear that you must defer to Congress and the executive agency.

  • RogerD

    In essence, health insurance under the Affordable Care Act is anything but affordable.

    • The bookman

      Unless of course you obtain a $4400 subsidy that isn't permitted under the terms of the law, but is allowed by the King, err, President of the United States. Then it's affordable. I mean, really, the intent was to subsidize every policy to the degree that maximized participation. Is it their fault they didn't include all the specifics in the law. No one read it anyway. It's the greater good. That's what's important, not whether it's legal, or paid for.