Two Courts Divided

Between January and March of this year, One Iowa held more than 60 events across the state to educate the lesbian, gay, bisexual and transgender (LGBT) community on the importance of the Affordable Care Act. 

Under the ACA, LGBT Iowans were impacted positively. Some were able to afford health insurance for the first time. Obviously, this has major implications for the well being of our community here in Iowa and across the country.

However, since its implementation, the ACA has been politically attacked and undermined from virtually every angle.

On Tuesday, two U.S. appeals courts reached opposite conclusions about a key provision of the Affordable Care Act, on the subsidies that help offset the cost of health insurance premiums for low-income individuals and families. 

A three-judge panel from the D.C. Circuit Court of Appeals ruled in Halbig v. Burwell that the ACA does not permit the IRS to distribute premium subsidies on health insurance exchanges established by the federal government. The 4th Circuit Court of Appeals based out of Virginia, however, said in King v. Burwell that the IRS does have the authority to issue the subsidies on federally run exchanges.

Iowa is among 15 states with exchanges that rely on the federal government to perform some important functions. If the Halbig ruling stands, the most vulnerable Iowans will no longer receive the assistance that makes health insurance affordable. 

A report from the Robert Wood Johnson Foundation estimates that 145,000 Iowa residents have enrolled in the Iowa exchange, with 78,000 people qualifying for subsidies totaling $396 million. The Halbig decision would make null and void these subsidies. 

For many LGBT Iowans—some who live in low-income households—this decision would be life changing. From a transgender individual on hormones to someone living with HIV or AIDS, this ruling would be a devastating blow to those people who, some for the first time, rely on the Affordable Care Act to maintain good, quality health care.

The two opposing decisions remind us just how important our courts are—and why we must maintain a fair and impartial judiciary. The Iowa Fair Courts Coalition, co-founded by One Iowa and Iowa Citizen Action Network in 2013, has worked to ensure that federal judges come to the bench with a wide breadth of diversity and experience. We also supported efforts that brought about the change necessary to fill the D.C. Circuit vacancies in late 2013.

Luckily, the three-judge panel from the D.C. Circuit ruling will likely be overturned by the court’s full en banc panel, which is made up a greater diversity of judicial appointees—many whom the Iowa Fair Courts Coalition urged our Senators to confirm.