Former President & CEO, INTEGRIS Health

A Liberal Interpretation

Published in The Journal Record
March 11, 2015

“Seek first to understand, then to be understood,” was Habit #5 in Stephen Covey’s landmark book, “The 7 Habits of Highly Effective People.” The basic principle of this habit was to say what you mean and mean what you say.

Apparently the Democrats in Congress failed to follow this principle when passing the Affordable Care Act. It is clear from editorials, TV coverage, and interviews during that period that the Democrats wanted to provide healthcare coverage for all Americans. Their method for providing this coverage was through the use of insurance exchanges. Each state was given the opportunity to develop its own exchange or allow the federal government to do it for them. Only thirteen states took advantage of this opportunity and developed their own exchanges. The primary method of getting insurance to low income Americans was to provide tax subsidies for people between 100% and 400% of poverty guidelines.

Now here’s the rub. The law clearly states those subsidies would be available in state exchanges, but makes no mention of subsidies for states with federal exchanges. Despite this limitation the IRS chose to adopt a liberal interpretation of the law and allowed subsidies in all states to all qualified applicants. As a result attorneys general in Oklahoma and other states have sued claiming the IRS has exceeded its authority. The Supreme Court is expected to deal with this complaint this summer. The issue is very clear. Does the law mean what it says and hence six to nine million Americans in states with federal exchanges should not have been eligible for these subsidies? Or, was the intent of Congress so clear that this was simply a clerical omission?

We are left with a handful of conclusions making the proponents of either side of this argument equally unattractive. Either the Democrats in Congress are so stupid or careless they allowed this oversight to occur, or the Republicans, by pressing the lawsuit and potentially overturning these helpful subsidies, are apathetic to the plight of the uninsured. They will appear to be self-righteous and even if technically correct, guilty of denying insurance for the first time to millions. A sad result for an ideological victory.

The Supreme Court gets to choose between stupidity on the one hand, and indifference on the other.

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