In an essay for this website a few weeks ago, my fellow columnist and friend Mike Dorf wrote about how the Obamacare statute (Act) might be in danger in the King v. Burwell case pending at the Supreme Court today because of things various Justices felt and said in the 2012 Obamacare case, National Federation of Independent Business v. Sebelius (National Federation). Mike focused particularly on the views expressed by four dissenting Justices in 2012 that the so-called individual mandate exceeded Congress’s powers and that the whole Obamacare statute was constitutionally invalid. I agree with Mike that the National Federation case is very relevant to the current dispute, but I see important ways in which Obamacare is less vulnerable, rather than more vulnerable, to the statutory challenge brought today because of what was said and done at the Court two years ago.
Background on the King v. Burwell and National Federation Cases
As Mike ably explained, the King v. Burwell lawsuit currently in front of the Justices asks whether a provision in the Obamacare law that permits federal tax credits to be given to qualified persons who purchase health insurance on an exchange “established by the State” also permits tax credits for individuals who purchase insurance on the so-called federal exchange that was set up (pursuant to the Act’s provisions) by the federal government in those states that chose not to set up exchanges themselves. According to the plaintiffs in King, federal tax credits are not available under the Act to citizens of states that did not set up Obamacare exchanges, because Congress wanted tax-credit eligibility to operate as an incentive for states to set up exchanges so that the federal government wouldn’t have to undertake the work.
Although the question is one of statutory construction, rather than constitutional authority, it has momentous implications; if federal tax credit subsidies are not available on the federal exchange, then a great many uninsured folks will remain uncovered, and a great many healthy individuals will be left out of the insurance market pools that experts say must be large and robust for Obamacare to work.
The question in King primarily comes down to the statutory meaning of the term “established by the State,” in the context of a large and complicated statute that uses this and similar terms in many different places, and that also directs the federal government, in those states that decline to erect exchanges, to set up “such” exchanges itself. I agree with Mike that the best reading of the complicated, interlocking statute—as a whole and in light of sensible canons of statutory construction—indicates that subsidies are available on federal exchanges, and that at the very least the Obama Administration is reasonable in embracing and acting on such an interpretation.
As Mike points out, however, Obamacare has many detractors, both on and off the courts, and some Justices may be looking for ways to avoid giving workable effect to the ambitious statute. Specifically, Mike analyzes the possibility that the four Justices who dissented in the 2012 National Federation case (Justices Scalia, Kennedy, Thomas, and Alito) might, notwithstanding the principle of stare decisis, stick to their 2012 stance—that the individual mandate runs afoul of the Tenth Amendment and the whole statute must be jettisoned—and continue to reject any application of Obamacare.
The scenario Mike posits is certainly plausible; stare decisis principles are pretty malleable and seem to be frequently ignored by many if not all of the Justices (albeit in different cases) in disputes involving the Tenth Amendment and other constitutional questions. Nonetheless, I am more sanguine than Mike about whether the four 2012 dissenters will brush aside stare decisis cautions and use their 2012 views to block Obamacare today, for two reasons.
First, a crucial bloc of the Supreme Court (with Justice Kennedy being a key member) in the famous 1992 Planned Parenthood v. Casey case involving the continuing vitality of Roe v. Wade, observed that when the Court, in the absence of “the most compelling reason,” overrules a “watershed” decision “under [political] fire,” it runs the risk of “subvert[ing] the Court’s own legitimacy beyond any serious question.” The National Federation ruling was a “watershed” moment for the Court, Obamacare remains “under [heavy] fire,” and a Supreme Court U-turn on Congress’s power to enact the law could be understood by many as a concession to the political pressure. Indeed, any 5-4 ruling next summer gutting Obamacare would no doubt be viewed by a wide swath of Americans first and foremost as a Republican-appointed Supreme Court doing the bidding for Republicans who don’t have the votes in Congress to repeal the divisive law.
Interestingly, this “don’t overrule under fire because to do so will damage institutional legitimacy” argument has more force here than it did even in Casey, because Roe itself was a decision that many analysts believed had the effect of undermining the Court’s legitimacy—insofar as Justice Blackmun’s majority opinion in Roe wasn’t tightly grounded in distinctively constitutional arguments—so that leaving Roe intact was not without legitimacy costs. Whatever one thinks of the National Federation ruling upholding Congress’s power to enact Obamacare, that ruling—because it deferred to rather than overrode the elected branches—has not opened the Court to the same kind of charge of sitting as an “unelected super-legislature” that Roe has.
My second reason for thinking the National Federation dissenters may have a somewhat tough time relying on their 2012 stance has to do with technical differences in stare decisis between constitutional interpretation cases and statutory construction decisions. Stare decisis is a rather flexible constraint in constitutional matters, whereas the Court has made clear that the bar for overruling a past decision that was construing a federal statute is particularly high (presumably because Congress can fix erroneous judicial constructions of statutes more easily than it can correct wrong-headed readings of the Constitution). As Mike pointed out, in the National Federation case, the dissenters thought that the mandate was unconstitutional, and “also thought that the entire law had to fall with the mandate.” That latter question—known in the business as “severability”—turned on how interlinked all the parts of the Act were, and whether any of the law could stand if the “pillar” (as the dissenters called it) of the mandate were invalidated.
The question of interrelationship between the various parts of Obamacare is ultimately a question of how best to read the statute and Congress’s intent. Five Justices in 2012 rejected the dissenters’ “pillar” reading, and although these five didn’t speak explicitly to the relationship between individual mandate in particular and the rest of the law, the majority certainly read the interrelatedness of the overall statute and Congress’s intent differently from how the joint dissenters did. So even if the four 2012 dissenters felt unbound by the National Federation Court’s ruling on whether the mandate exceeds federal authority, they would also (in order to block Obamacare because of the mandate today) have to explain why they should not obey the 2012 majority’s statutory interpretation on the question of severability. It would not be impossible for the 2012 dissenters to make some arguments here, but such arguments might look result-oriented when they minimize the effect of statutory stare decisis, ordinarily an uncontroversial topic.
How the National Federation Case Bolsters Obamacare Against the Current Challengers
There is another aspect of the National Federation case, an aspect on which seven Justices (including the joint dissenters) agreed, that bolsters rather than weakens Obamacare against its current challengers. I refer here to the Medicaid expansion part of the 2012 decision, in particular the Court’s holding that Congress could not “surprise[e]” states by enforcing terms of a Medicaid bargain that were not “unambiguously” declared when the Medicaid deal was offered to states decades ago. Because the statutory provision entitling Congress to make alterations or amendments to Medicaid could “reasonably” be “assume[d]” by states to mean that Congress can make “adjustments” but not “transform[ations], states were protected against substantial retroactive conditions Congress sought to attach.
National Federation is just the latest in a line of case in which the Court has noted that “legislation enacted pursuant to the spending power [when the federal government is offering money to states to promote the general welfare] is much in the nature of a contract,” and that the legitimacy of deals offered to states:
rests on whether the State voluntarily and knowingly accepts the terms of the “contract.” There can, of course, be no knowing acceptance if a State is unaware of the conditions or is unable to ascertain what is expected of it. Accordingly, if Congress intends to impose a condition on the grant of federal moneys, it must do so unambiguously. By insisting that Congress speak with a clear voice, we enable the States to exercise their choice knowingly. . .
The theory behind this requirement that Congress speak “unambiguously” and with a “clear voice” seems pretty straightforward (even though the Court has not spent a lot of ink elaborating it): Because states are worthy of special respect as important partners in our federal system, we want to minimize the risk that states accept or forgo federal moneys without an accurate sense of the consequences of their actions.
How does this play out in King? Well, even if the challengers are correct that the best reading of the phrase “established by the State,” in the context of a complicated 900-page statute, means that Congress did not intend for citizens of states that did not set up exchanges to be able to obtain the tax credits, it’s hard to believe that the statute puts states on clear notice of that consequence. The statute never explicitly says (in so many words) that a state that does not set up an exchange gives up tax credits for its residents. And this Congressional message—if it be a message—seems not to have been effectively communicated. After all, various judges in the D.C. and Fourth Circuits don’t read the statute the way the King challengers do. The I.R.S. hasn’t read the statute the way the challengers do. One of the architects of the challenge (who was presumably familiar with the big aspects of the law shortly after its enactment) is reported to have said he was “surprised” when he discovered the reading that he now embraces. Key members of Congress did not publicly communicate the reading of the statute the challengers assert at the time of enactment. I am aware of no journalist who offered that interpretation of the statute at the time it was passed and presented to the states.
And, most importantly, states do not seem to have said or done things that suggest they actually understood the statute the way the challengers do, at the time decisions were made about whether to set up an exchange in each state. (If there are states that took actions indicating they understood “the deal,” such actions should be highlighted.) The absence of state conduct suggesting awareness is particularly powerful, because as to the Medicaid expansion provisions that were litigated in National Federation, governors in states that declined the expansion did feel obligated to defend to their voters the decision to turn down federal money. No such explanations seem to have been offered by governors or legislators in states that decided not to set up exchanges about why turning down federal money was the right thing to do notwithstanding the cost. And one would certainly expect a lot of explanation if states understood they were giving up tax credits for their citizens.
Even the joint dissenters in National Federation, in describing the way exchanges would work, seemed not to see the deal the King plaintiffs say Congress offered. The dissenters observed that, in order to accomplish its statutory goal of near-universal coverage, “Congress provided a backup scheme” for those states that did not set up exchanges: “If a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State.” The implication in this passage is that the Federal Government’s exchange would operate, as regards the goal of making insurance coverage more available, just as a state-established exchange would.
It is of course possible that the statute is “unambiguous” and “clear” in offering the deal the challengers assert, and that most everyone simply missed that clarity for months leading up to and following from the law’s enactment. That judges and Justices, and journalists, and law professors, and members of Congress, and governors and state legislators all failed to see this plain aspect of the statute does not mean that it is not there. To the extent that the Court’s doctrine does not require actual, subjective knowledge by states (a true meeting of the minds) as to what is expected of them, but rather only an easy ability to ascertain what the expectations are (a question Supreme Court cases don’t fully answer, as far as I am aware), then the fact that many reasonable people didn’t notice something doesn’t mean there wasn’t notice.
But even if the test focuses only on objective clarity—a plain statement of the contract terms so that states can know what they are getting into or turning down—it’s hard to see how the challengers’ reading of Obamacare can prevail. Can anyone really credibly argue that states were put on more clear notice of the loss of tax-credits by the use of the term “established by the State” alongside the federal power to create “such” exchanges in the context of an interlocking and convoluted statute than they were that Congress might make major changes to future Medicaid eligibility when Congress explicitly reserved for itself the power to “alter, amend or repeal any provision” of the Medicaid program (the term at issue in National Federation)? The challengers’ reading of the statute (even assuming it is the best overall reading) is clearly visible only in the way Waldo’s whereabouts are plain and clear after your child circles him with a highlighter on the page for you. If the deal Congress offered to states (according to the Obamacare challengers) was clearly presented in the statute, then we will have effectively overruled the “clear voice” requirement altogether, which is something a Court that is supposed to care about federalism should be loath to do.
In Part Two of this series, to be posted next Monday, I take up counterarguments and additional questions raised by this federalism defense of federal exchange tax credits, including: (1) Why this federalism argument might be particularly important; (2) Why this federalism argument doesn’t involve the same inquiry as so-called Chevron deference to administrative agency interpretation; and (3) Why federal tax credits to individual state citizens should be treated the same, for these purposes, as federal moneys given over to state coffers.