Timothy S. Jost Outlines King v. Burwell Arguments and Effects of the Decision

One point of concern among Justices Anthony Kennedy and Sonia Sotomayor during the oral arguments of King v. Burwell was the issue of unconstitutional coercion, and Timothy S. Jost, professor of law at Washington and Lee University School of Law, explains the main issue.

The argument maintains that Congress, in passing the Affordable Care Act (ACA), was telling states they had to set up their own exchanges or they wouldn't receive subsidies and their insurance markets would be ruin, which is considered unconstitutional coercion. Similarly, in the last lawsuit against the ACA, the Court ruled that Congress could not have forced states to participate in Medicaid expansion programs.

In addition, Mr Jost addressed what could prevent so-called "death spirals" occurring in the insurance markets of states on the federally facilitated marketplace as a result of the Supreme Court ruling that individuals purchasing plans through HealthCare.gov are not eligible for subsidies.

"It's basically going to be up to Congress," he said. "And Congress could fix this tomorrow. Congress could pass a statute saying 'What we meant was federally facilitated as well as state-operated exchanges.' They don't seem willing to do that."