Guest post: Jessie Kavanagh, Health Policy Intern at Community Service Society of New York
Last week, a 3-judge panel of the U.S. Court of Appeals for the District of Columbia ruled 2-1 that states using the federally-facilitated marketplace (healthcare.gov) cannot offer government subsidies to their residents. The same day, a 4th U.S. Circuit Court of Appeals in Virginia unanimously came to the opposite conclusion– that the states using the federal marketplace should be able to offer subsidies.
What to make of this conflict? Regardless of the disagreement, the bottom line for New Yorkers is simple: the decisions have no immediate impact on New Yorkers’ eligibility for the ACA tax credits and subsidies.
The main issue in these cases concerns the language in the ACA regarding the subsidies. The language states that subsidies are only available “through an exchange [aka marketplace] established by the state.” The U.S. Court of Appeals for the DC Circuit argued that this language means subsidies should be available only to people who enroll through a state-based marketplace. However, the 4th Circuit Court said that the law was ambiguous, and that the IRS was entitled to its interpretation that the federal marketplace acts as a state’s marketplace, and therefore all states can offer subsidies to their residents.
Ultimately, the ACA was written with the intent to make insurance more affordable for all Americans. And, it seems to be working. In New York, 3 out of 4 enrollees in commercial Qualified Health Plans during open enrollment- or 274,247 New Yorkers – were eligible for tax credits that made insurance more affordable.