House v. Burwell: Obama admin says court shouldn't meddle in ACA subsidy dispute

Statue holding justice scales

In a new court filing, the Obama administration criticizes the House of Representatives for meddling in the appropriation of funds for the Affordable Care Act’s insurance subsidy program.

The brief was filed Monday by Department of Health and Human Services Secretary Sylvia M. Burwell and Treasury Secretary Jacob Lew as part of the Obama administration’s appeal of a May ruling in favor of the plaintiffs in House v. Burwell. They argue that the House’s lawsuit--not the administration’s appropriation of funds for the ACA’s cost-sharing-reduction programs--is unconstitutional.

The long-standing dispute between Congress and the administration over the House’s allegation that the administration is misinterpreting an ACA statute isn't an issue that falls within the scope of judicial resolution, according to the brief.

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Disagreements over legal statutes between lawmakers and the executive branch are routine, but they have always been solved by “the give-and-take of the political process," not by resorting to the courts, the brief argues. In keeping with the Constitution's separation-of-powers principles, the judicial branch has historically been relied on to remain apolitical, it adds.

At stake in the case is the legality of the ACA’s cost-sharing-reduction programs--as of 2016, up to seven million enrollees were receiving CSRs, FierceHealthPayer reported.

If the CSR payments to insurers are halted, payers would still be legally bound to continue providing subsidies for consumers, which could translate to another $7 billion expense this year and $130 billion over the coming decade, health policy expert Tim Jost writes in a Health Affairs Blog post.

If the House ultimately prevails, a clause included in the recent qualified health plan contract would offer insurers some relief, Jost has noted previously. That's because it acknowledges these insurers could have cause to terminate their QHP contracts--though they still would be obligated to provide coverage for its QHP enrollees for the full year under applicable state law.

In an email to FierceHealthPayer, a Justice Department spokeswoman declined to comment beyond the government's brief.