Ka Wai Ola - Office of Hawaiian Affairs, Volume 32, Number 3, 1 March 2015 — OHA takes a stand on U.S. Supreme Court case on health insurance law [ARTICLE+ILLUSTRATION]

OHA takes a stand on U.S. Supreme Court case on health insurance law

By Lisa Asato The Office of Hawaiian Affairs has signed on to a legal brief urging the U.S. Supreme Court to preserve certain tax subsidies of the Affordable Care Act, the federal law that aims to make health insurance affordable for Americans. In January, the Asian and Paeihe Islander American Heahh Forum (APIAHF) and three other national groups filed an amicus brief or friend-of-the-court brief in the King v. Burwell case. Sixty-three organizations, including OHA, signed on in support of the brief. The groups want to preserve important subsidies that make heahh care affordable for all people in all states, regardless of whether the state runs its own heahh exchange or relies on the federal marketplace, healthcare.gov. The King v. Burwell case is seeking to strike down this essential component of the Affordable Care Act. The lawsuit challenges federal tax credits and subsidies for those signed on to the federal marketplace, arguing subsidies should only be available to those who purchase insurance on a state-run heahh exchanges. The challenge relies on language in that Act authorizing subsidies

through state exchanges. Iyan John, senior policy analyst whh the San Francisco-based APIAHF, said limiting the subsidies to only state marketplaces is a narrow reading of the law, whieh aims to provide subsidies to all who qualify. "The intent of the law was to help everyone regardless of where they live," John said. He said there is precedent for the nation's high court ruling in favor of the intent of a law in its entirety. "If you look at the law as a whole this one speeihe line the petitioners are focusing on really is not reflected in any other part of the law," he said. "There's precedent for looking at the entirety of the statute not just one line or two lines of the statute to get meaning." According to the legal brief: "The subsidies are an essential component of the Affordable Care Act that enahle it to achieve its critical objectives of increasing access to heahh care to all uninsured individuals and reducing health care costs. A determination in favor of Petitioners would subvert these core purposes and defeat Congress's explicit intent. Indeed, denySEE SUPREME C0URT ON PAGE 9

United States Supreme Court Building, Washington, DC. - Photo : Thinkstock

SUPREME COURT Continued from page 5 ing needed federal subsidies to those who purchase policies on federally-facilitated Exchanges would so undermine the marketplaces that are the backbone of the Affordable Care Act that it would inflict devastating harm on those most in need, including low-ineome Asian Americans, Native Hawaiians, and Pacific Islanders and other racial and ethnic eommunities." The filing includes testimonials from individuals who have benefited from the subsidies to show personal stories that "subsidies have enabled millions of previously uninsured or uninsurable individuals of all races and in all states to obtain and afford the heahh care that they need." If the subsidies are pulled, the states using state-run heahh exchanges would be indirectly affected, John said. That's because when heahh insurance becomes less affordable, healthier populations are more likely to forego coverage, leaving sicker populations insured. That raises premiums, whieh will affect states across the board, he said. Hawai'i has a state-run marketplace, as do 15 other states and the District of Columbia. Kealoha Fox, OHA's Ka Pou Kako'o Nui, or executive manager, said ensuring access to heahh care is part of OHA's

philosophy on well-being. Minority and underserved populations across the country, including Asian Americans, Native Hawaiians and Pacific Islanders in general tend to laek access to care and have lower rates of insurance for themselves and their families, she said. The Affordable Care Act, through its subsidies, provides an avenue of relief and should be maintained, she said.

"We believe that optimum heahh of kānaka 'ōiwi is achievable through social justice and indigenous rights, including supporting Native Hawaiians' ability to access all the benefits of society," she said. "This translates to OHA advocating for improved access to heahh care as an important indicator in achieving greater heahh equity for our people, especially heahh care that is more available, and more affordable, for

Native Hawaiians and our families." OHA Chief Advocate Kawika Riley said it's not often that OHAjoins in a friend-of-the-court brief, "but when something rises to this level and you have an opportunity to be part of a eoalhion of voices advocating for something that benefits our lāhui (nation) you have to take h. And that's what OHA did in this instance." "While Hawai'i is the healthiest plaee in the nation by various indicators, we (Hawaiians) have some of the greatest heahh challenges of any population in our state. Access to affordable, quality heahh care is necessary to improve the well-being of Native Hawaiians," he said. "When people reach that point when they require heahh care, it's important that they have it. It's also important for people to have access to quality heahh care so they get the checkups to prevent a lot of these long-term chronic debilitating heahh conditions." The three national organizations that joined APIAHF in the filing are the Association of Asian Pacific Community Heahh Organizations, andboth the Fos Angeles and Washington D.C. Asian AmericansAdvancing Justice. The fourgroups comprise the Action for Heahh Justice, whieh in the first year of enrollment helped 600,000 people through outreach, education and assistance, including overcoming language barriers, said John, of APIAHF. The court was to hear oral arguments in the case on March. 4. A decision is expected around early June. ■

The intent of the law was to help everyone regardless of where they live." — Iyan John, senior policy analyst, APIAHF