U.S. House of Representatives v. Burwell — May 2016 (Summary)

AFFORDABLE CARE ACT

U.S. House of Representatives v. Burwell
No. 14-1967 (RMC) (D.D.C. May 12, 2016)

The United States District Court for the District of Columbia entered summary judgment in favor of the United States House of Representatives in a suit brought against the Secretary of the United States Department of Health and Human Services (“HHS”) and the United States Treasury.  The court enjoined the use of unappropriated monies to reimburse cost-sharing subsidies offered by insurers under Section 1402 of the Affordable Care Act.  Section 1402 of the Affordable Care Act requires insurers offering qualified health plans through the Affordable Care Act exchanges “to reduce deductibles, coinsurance, copayments, and similar charges for eligible insured individuals enrolled in their plans, with the government providing reimbursement to insurers for these cost-sharing reductions.”

The court distinguished Section 1401 of the Affordable Care Act, which provides tax credits to subsidize health insurance for certain individuals, noting that these tax credits are permanently funded by law.  However, the Section 1402 cost-sharing subsidies are annually funded.  Thus, paying out reimbursements for these subsidies by HHS and the Treasury without an annual appropriation from Congress violates the Constitution.  The court concluded that “Congress authorized reduced cost sharing but did not appropriate monies for it, in the FY 2014 budget or since.  Congress is the only source for such an appropriation, and no public money can be spent without one.”  The court stayed its injunction pending any appeal by the parties.