Supreme Court takes up major fight over health care law

Mark Sherman
Associated Press

Washington — Divided along familiar lines, the Supreme Court took up a politically charged new challenge to President Barack Obama’s health overhaul Wednesday in a dispute over the tax subsidies that make insurance affordable for millions of Americans.

During an unusually long oral argument, several members of the court, including potential swing Justice Anthony Kennedy, warned of a "death spiral" that might occur from a ruling that cuts off insurance subsidies in 34 states that rely on a federal health exchange.

The outcome in what Justice Elena Kagan called “this never-ending saga” of Republican-led efforts to kill the Affordable Care Act appears to hinge on the votes of Chief Justice John Roberts, whose vote saved the law three years ago, and Kennedy.

Roberts said almost nothing in Wednesday’s 85 minutes of lively back-and-forth, and Kennedy, who voted to strike down the health law in 2012, asked questions of both sides that made it hard to tell where he might come out this time.

Kennedy said limiting the tax credits to 16 states, as a group of challengers urge, would create a “serious constitutional problem.”

Otherwise, the same liberal-conservative divide that characterized the earlier case was evident in the packed courtroom with the same lawyers facing off as in 2012.

At issue is the legality of the subsidies for an estimated 7.5 million subscribers in the 34 states, including Michigan, that chose not to run their own health insurance exchanges, leaving it to the federal government. Critics argue that the law, as written, permits the subsidies to go only to people who use state-run exchanges. The administration says the subsidies were intended to be available in all states.

Kathe Koja, a writer and producer who lives in the Detroit area, says she won’t be able to afford her health care premiums through the exchange if she loses her subsidy.

She traveled to Washington to demonstrate outside the high court with others affiliated with the nonprofit group Families USA.

“I hope the Supreme Court will be able to see this case is baloney,” she said Wednesday outside the Supreme Court building. “I don’t know what my other options would be.”

Highland Park resident Vanita Johnson said she went without insurance for about three years after she was laid off in 2010. She had worked as public safety officer for 40 years, last serving at Kettering High in Detroit.

Now a security officer at the College of Creative Studies, Johnson has health insurance through the Healthcare.gov marketplace but wouldn’t be able to afford the unsubsidized premiums, which she estimates would be around $400 a month for herself and her 21-year-old daughter. Johnson currently pays $102 a month toward her coverage, she said.

“Being without insurance causes anxiety, which is not healthy,” said Johnson, who spoke to a crowd of demonstrators outside the court.

Liberal justices peppered lawyer Michael Carvin almost from the outset of his argument to limit the subsidies.

Justice Ruth Bader Ginsburg said the law set up flexibility for states to either set up their own markets or rely on federal healthcare.gov. Giving subsidies only to people in some states would be “disastrous,” she said. “I have never seen anything like this.”

A decision in the case is expected by late June.

Detroit News Staff Writer Melissa Nann Burke contributed.