Get Covered AmericaThe good folks over at Get Covered America, who have been working tirelessly and with great success to get hundreds of thousands of North Carolinians into affordable health insurance over the last several months despite the mean-spirited obstructionism of the state’s conservative political leadership, issued the following common sense response to today’s competing U.S. Court of Appeals rulings:

Today the Federal Court of Appeals for the Fourth Circuit, which covers North Carolina, ruled in the King v Burwell case that the U.S. Internal Revenue Service does have authority to issue tax subsidies in states with a federally facilitated marketplace such as North Carolina. In a separate ruling today, the federal court in DC ruled differently. The end result, is that nothing changes for the 357,584 North Carolinians that already enrolled in insurance on the federal marketplace and nothing changes for those who can still enroll now. While the legal process takes its course, Get Covered America-North Carolina staff and volunteers will continue to reach out to uninsured North Carolinians and let them know about the financial help that continues to be available to them during the current Special Enrollment Period and the upcoming Open Enrollment Period beginning in November. The financial assistance made available by the Affordable Care Act to help consumers afford health coverage has made a huge difference for thousands of North Carolinia families. In fact, 91% of North Carolinians who enrolled in insurance on the federal marketplace are receiving financial assistance to pay for it. The clear intention of the law is to make health insurance affordable for all Americans. (Emphasis supplied.)

A new report by the Annie E. Casey Foundation provides a sobering look at how children are faring in North Carolina.

The 2014 KIDS COUNT Data Book, which looks at 16 separate factors, ranks our state 38th in overall economic well-being, 28th in education, and 32nd in health.

KIDS-COUNTpoverty-graphic1

Source: KIDS COUNT Data book http://www.aecf.org

The annual report concludes:

‘Although unemployment is slowly declining, job growth has been concentrated in low-wage sectors and in nonstandard employment that tends to be less stable and offer few or no benefits, such as health insurance and paid sick leave.

A stronger labor market and an increase in job quality, along with continued efforts to boost the education and training levels of low-income parents, would help to further reduce child poverty.’

In North Carolina, 26% of children lived in poverty in 2012, according to the new report.

Locally, the Inter-Faith Food Shuttle is working to help address this problem by creating long-term solutions to hunger for North Carolina’s low-income families.  To learn more about this week’s special HungerFreeNC community movement, click here.

Hear more about food insecurity from the Food Shuttle’s executive director Jill Bullard on News and Views with Chris Fitzsimon.

Also be sure to watch Thursday’s documentary “Hungry for Answers” at 7:00 p.m. on WRAL-TV.

A unanimous panel of the Fourth Circuit in Richmond has upheld the availability of Affordable Care Act tax credits to health insurance purchasers on both state exchanges and the federal exchange.

The decision in King v. Burwell comes just hours after the D.C. Circuit Court of Appeals issued a contrary ruling in Halbig v. Burwell.

Writing for the court, Judge Roger Gregory said:

The plaintiffs-appellants bring this suit challenging the validity of an Internal Revenue Service (“IRS”) final rule implementing the premium tax credit provision of the Patient Protection and Affordable Care Act (the “ACA” or “Act”). The final rule interprets the ACA as authorizing the IRS to grant tax credits to individuals who purchase health insurance on both state-run insurance “Exchanges” and federally-facilitated “Exchanges” created and operated by the Department of Health and Human Services (“HHS”). The plaintiffs contend that the IRS’s interpretation is contrary to the language of the statute, which, they assert, authorizes tax credits only for individuals who purchase insurance on state-run Exchanges. For reasons explained below, we find that the applicable statutory language is ambiguous and subject to multiple interpretations. Applying deference to the IRS’s determination, however, we uphold the rule as a permissible exercise of the agency’s discretion. We thus affirm the judgment of the district court.

Judge Andre Davis, who took senior status in late February, took the court’s analysis one step further, writing in concurrence that, ambiguity aside, tax credits should be available to all consumers regardless of the exchange on which they purchased their health insurance.

Davis said:

I am pleased to join in full the majority’s holding that the Patient Protection and Affordable Care Act “permits” the Internal Revenue Service to decide whether premium tax credits should be available to consumers who purchase health insurance coverage on federally-run Exchanges. But I am also persuaded that, even if one takes the view that the Act is not ambiguous in the manner and for the reasons described, the necessary outcome of this case is precisely the same. That is, I would hold that Congress has mandated in the Act that the IRS provide tax credits to all consumers regardless of whether the Exchange on which they purchased their health insurance coverage is a creature of the state or the federal bureaucracy.

Davis acknowledged the right of those who challenged the subsidy provision to forego purchasing health insurance on an exchange, but he added this:

What they may not do is rely on our help to deny to millions of Americans desperately-needed health insurance through a tortured, nonsensical construction of a federal statute whose manifest purpose, as revealed by the wholeness and coherence of its text and structure, could not be more clear.

In both cases, the decisions may be reviewed by a full panel of  judges in the circuit (en banc), and others are percolating in district courts elsewhere across the country. But a resulting, continuing conflict in the circuits increases the likelihood of a review by the U.S. Supreme Court.

In the meantime, as the Obama administration has indicated, subsidies will continue.

That’s good news for North Carolina residents who purchased health insurance on the federal exchange. (North Carolina did not set up a state exchange). Of the 358,000 who did so, 91 percent (325,000) did so with the assistance of subsidies.

Read the full opinion in King v. Burwell here.

 

 

The U.S. Court of Appeals for the D.C. Circuit has ruled that tax credits under the Affordable Care Act can only be available to people who enrolled in new exchanges set up in states — not those who enrolled in the default federal program.

Think Progress explains the 2-1 decision in Halbig v. Burwell:

The two Republicans’ decision rests on a glorified typo in the Affordable Care Act itself. Obamacare gives states a choice. They can either run their own health insurance exchange where their residents may buy health insurance, and receive subsidies to help them pay for that insurance if they qualify, or they can allow the federal government to run that exchange for them. Yet the plaintiffs’ in this case uncovered a drafting error in the statute where it appears to limit the subsidies to individuals who obtain insurance through “an Exchange established by the State.” Randolph and Griffith’s opinion concludes that this drafting error is the only thing that matters. In their words, “a federal Exchange is not an ‘Exchange established by the State,’” and that’s it. The upshot of this opinion is that 6.5 million Americans will lose their ability to afford health insurance, according to one estimate.

But the fight over this issue is far from over.

As Policy Watch noted last week, the same question is currently pending before the Fourth Circuit in Richmond in King v. Sebelius, with a decision expected any day.

And the ruling from the D.C. Circuit is likely to go to the full panel,  according to Vox:

This decision comes from three judges on the D.C. Circuit. The federal government will probably ask the entire D.C. Circuit — eleven judges in total — to review the decision “en banc.” The court skews to the left (there are seven Democratic appointees and only four Republican appointees) which bodes in the administration’s favor. En banc review probably won’t happen until early fall.

Read the full opinion in Halbig v. Burwell  here.

"Healthywealthy" by threestooges.net. Licensed under Fair use of copyrighted material in the context of Healthy, Wealthy and Dumb via Wikipedia - http://en.wikipedia.org/wiki/File:Healthywealthy.jpg#mediaviewer/File:Healthywealthy.jpg

“Healthywealthy” by threestooges.net. Licensed under Fair use of copyrighted material in the context of Healthy, Wealthy and Dumb via Wikipedia

No, this post is not an attempt to personally disparage the folks running North Carolina government. Rather it is an attempt to conjure up an image that captures the impact of the decisions that state leaders have been inflicting of late on their brethren and sistren at the local level.

As some readers will recall, The Three Stooges were an outlandish and slapstick comedy trio that had a long run in the middle part of the last century. In one of the trio’s recurring bits, one Stooge (usually Moe – pictured on the left) would slap or punch the second Stooge, who would then, in turn punch the third member of the group. The third and most hapless Stooge would then turn beside him and find that he only had thin air to punch.

Sadly, this comedy bit pretty well captures the essence of what’s going on in North Carolina government right now: Whether it’s the McCrory-Pope team or the General Assembly that starts the punching, the ones left flailing at thin air are local governments.

For the latest classic example, check out the bill under consideration in the state Senate during the waning days of the 2014 session that would hamstring local governments in their ability to raise local sales taxes for important needs. While Senators sought to alter some of the the impacts of the bill last evening, it still promises to have a deleterious impact — especially on big counties like Wake and Mecklenburg. And, of course, this comes on the heels of several previous haymakers in which state leaders have slashed state support for locals.

The bottom line is that the overarching policy of the current conservative state leadership when it comes to local government is this: We’re all for local control that’s closest to the voters — except when we’re not (i.e. any time anyone at the local level even thinks about doing something — like raising taxes to provide essential public services — with which we disagree). SLAP!!!