Healthcare.jpgIn January, we reported that the Supreme Court of the United States granted review in King v. Burwell to decide whether under the Patient Protection and Affordable Care Act (ACA) the Federal Government could offer subsidies to individuals who purchase health insurance through federally-funded exchanges.  The ACA requires all Americans to have health insurance or pay a fine.  As an incentive for individuals to purchase health coverage, the ACA encourages states to create exchanges, or marketplaces, where individuals can shop for insurance. Federal exchanges operate in states that fail to establish their own exchanges.  California is one of fourteen states that created a state exchange, known as Covered California.  To make insurance affordable for low-income consumers, the ACA offers federal subsidies, or tax credits, to qualified individuals through the state and federal exchanges.  Approximately three-dozen states have federally-run exchanges with more than six million people receiving subsidies through these federal exchanges.

Yesterday, the Supreme Court ruled that ACA permits the Federal Government to provide subsidies to qualified individuals through both state and federally-run exchanges.  The Supreme Court’s holding answered the question of whether an ambiguous phrase in the law was to be interpreted to only permit the Federal Government to provide subsidies to individuals who bought insurance through “Exchanges established by the State,” but not available through the federally-run exchanges.

The Internal Revenue Service’s (IRS) ACA regulation says that subsidies are permitted in state and federally-run exchanges. The plaintiffs/appellants argued, however, that the plain language of the ACA, which reads that qualified tax payers may receive subsidies when enrolled in “[e]xchanges established by the State,” precluded subsidies for persons enrolled in federally-run exchanges.

The Supreme Court agreed with the IRS’ interpretation, finding that “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”  Interpreting the statutory language to prohibit subsidies in federally-run exchanges would destabilize the individual insurance market, a central tenet of the ACA, and have disastrous economic consequences which Congress did not intend.

As California established a state-run exchange, this Supreme Court decision does not have direct implications for California.  However the June 25, 2015 decision could have long term impacts, including signaling that the ACA’s statutory language should not be interpreted in a way that diminishes individual rights’ to purchase affordable and minimum essential health care coverage.

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Photo of Alysha Stein-Manes Alysha Stein-Manes

Alysha Stein-Manes primarily represents Liebert Cassidy Whitmore’s educational institution clients in a range of employment, labor, and student matters.

Alysha regularly advises community college districts on academic and classified employee evaluation and discipline; administrator contracts and evaluation; equal employment opportunity recruitment and hiring…

Alysha Stein-Manes primarily represents Liebert Cassidy Whitmore’s educational institution clients in a range of employment, labor, and student matters.

Alysha regularly advises community college districts on academic and classified employee evaluation and discipline; administrator contracts and evaluation; equal employment opportunity recruitment and hiring practices; discrimination, harassment, and retaliation investigations; general governance matters; California and federal Voting Rights Act compliance; government transparency under the Brown Act and California Public Records Act; and a variety of student matters.  She is also experienced working with governing boards on conducting CEO evaluations and contract negotiations, as well as advising and training boards on ethics, Brown Act, and other governance issues.

Alysha also regularly represents community college districts in arbitrations and administrative proceedings regarding discipline of permanent employees and the release of probationary faculty members, and in matters before the U.S. Equal Employment Opportunity Commission, California Department of Fair Employment and Housing, and California Office of Administrative Hearings.

Alysha provides counsel to private institutions of higher education, in matters including the intersection of student disability accommodations and discipline; personnel policies and practices; employee evaluation and discipline; Family Education Rights and Privacy Act (“FERPA”); and discrimination and harassment complaints and investigations.

Alysha is also a leader in the retirement and health arenas.  She regularly provides counsel to LCW’s clients about the Affordable Care Act and disability interactive process, and to LCW’s public agency clients in the areas of the post-retirement work restrictions, PEPRA compliance, and reporting employee compensation to CalSTRS and CalPERS.

Alysha has extensive experience as a litigator, representing public agencies and non-profit educational institutions at all levels of the litigation process in state and federal court

Alysha serves on the Executive Committees for LCW’s Public Education Practice Group and Retirement, Benefits, and Disability Practice Group.

Prior to joining LCW, Alysha served as an Education Policy Analyst for former Los Angeles Mayor Antonio R. Villaraigosa.  In this role, she advised and developed communications strategies for the Mayor’s education platform and initiatives.  Alysha also advocated for federal grants and legislation at local, state and federal levels, and managed collaborative and multi-dimensional projects between mayoral and school district staff and labor, business and non-profit stakeholders to improve educational outcomes for the children of Los Angeles.