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A11-1847 State v. Campbell (St. Louis County)

Health care ruling sets off partisan responses

With apologies to the U.S. Supreme Court’s most outspoken conservative, Thursday really belonged to just about everyone except for Justice Antonin Scalia.

Scalia garnered a lot of headlines for a frank, at times incendiary dissenting opinion about the Affordable Care Act, aka Obamacare, which, he wrote, should now be known as “SCOTUScare,” due to the massive role the high court has played in the law’s preservation.

The court ruled 6-to-3 in favor of the current implementation of the law on Thursday, roughly three years to the day after a 5-to-4 majority rejected a challenge to the health reform law’s constitutionality. Thursday’s ruling in the King v. Burwell was more narrowly focused than the previous challenge, but no less important to the functioning of the landmark legislation.

At issue was the operation of state health insurance exchanges, and whether consumers in states that deferred to the federal government were still eligible for federally subsidized insurance plans.

Writing for the majority, Chief Justice John Roberts said regardless of passages that are less than clear, lawmakers clearly intended for the subsidies to be available in all states, and not just those that run their own exchanges.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts said.

As one of the states that had established its own online marketplace, Minnesota was not at risk of any adverse outcome as a result of the ruling, as interim MNsure CEO Allison O’Toole had assured the public before the opinion’s release. Indeed, that was never a risk: Earlier this year, when Republicans pushed for Minnesota to scrap its local operation and default to the federal, they included language that would have preserved the state exchange if the Supreme Court had ruled otherwise.

Still, the ruling immediately set off another round of partisan responses. Gov. Mark Dayton, who was then holding a separate press conference, was relieved at the news, and said he hoped it would finally bring an end to conservative opposition in the face of existing law. While Minnesota wasn’t subject, individually, to the court’s decision, a ruling that eliminated subsidies for other states would have “thrown the whole system into chaos,” Dayton said.

“I really hope the critics will recognize now that this is the system that’s been enacted, it’s federal law, and we’re going to work to make it better,” Dayton said.

After debating a variety of options this session, lawmakers agreed only to convene a task force assigned with studying healthcare financing, “including alternatives to MNsure,” which is due to make recommendations to the Department of Human Services (DHS) and ranking legislators by January 15 of next year.

Rep. Matt Dean, R-Dellwood, chair of the House Health and Human Services Finance Committee, made his own recommendations for MNsure reform clear in a Facebook post that appeared Thursday morning. Dean wrote that the court opinion should only bolster the argument in favor of eliminating MNsure, and defaulting to federal control, because the state’s consumers would still have the same tax incentives.

“That means the main argument to set [MNsure] up is now gone,” Dean wrote.

The post received a handful of “Likes” in short order; among those in support was Sen. Michele Benson, R-Ham Lake, minority lead on health and human services topics in the Senate. Benson’s caucus leader, Senate Minority Leader David Hann, was more explicit with his own feelings, issuing a statement saying the ruling “makes it clear Minnesota never should have wasted nearly $250 million” to launch “the defective MNsure system we have now.”

On the federal level, DFL U.S. Rep. Tim Walz, a moderate who has given guarded support to Obamacare, said the law is “not perfect,” but “is working.”

Said Walz: “While I will work with anyone who is genuine in their attempts to improve the law, I will fight vigorously against repeal.”

Republican U.S. Rep. Erik Paulsen said regardless of the court ruling, consumers “still need better patient-centered solutions,” and vowed to continue his efforts to repeal the medical device tax passed as part of the Affordable Care Act.

Dayton, who has spent nearly four decades in public service, said the Republican reaction to Obamacare is unique in his memory.

“I’ve never, in my political career, seen this ongoing assault against a program that’s passed by Congress, signed into law … and upheld by the U.S. Supreme Court,” Dayton said. “Again and again, [it’s] battered and battered, making people uncertain about it. I hope this puts that to a halt.”

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