This morning, the Supreme Court of the United States will hear arguments in the King v. Burwell case. King v. Burwell was filed to challenge federal financial assistance for people in states that have Federally Facilitated Marketplaces (FFM). New York, which operates a State-Based Marketplace (SBM), can continue to provide insurance subsidies regardless of the Court’s decision. However, if the Court sides with the plaintiff, more than 9 million people could lose the federal premium subsidies that help them afford insurance and more than 8 million could become uninsured in the 34 states operating FFMs (see a recent study by the Urban Institute).
At the heart of the case is a bit of language in the Affordable Care Act that says subsidies will be available to exchanges “established by the state.” The plaintiff argues that this language means that only states with their own Marketplaces, like New York, can provide premium subsidies and cost-sharing reductions to enrollees. But the government and supporters – including several of the laws’ authors and 22 states that filed an amicus brief – say that they never understood that choosing whether or not to run a SBM would impact access to subsidies for state residents. And more importantly, denying subsidies for those millions enrolling through healthcare.gov directly conflicts with the intent of the ACA to provide “quality, affordable care for all Americans.”
While this case does not directly impact New Yorkers, there is no question that denying affordable health care for the millions of people around the country who rely on healthcare.gov would be a very bad thing. The impacts of such a decision could ripple through the health care system and affect consumers and providers around the country. We will continue monitoring the case as the Court comes to a decision in early summer. In the meantime, you can also follow developments via the Wall Street Journal live blog of the proceedings, social media (@hcfany, #KingvBurwell, #DontDenyUs, #DontTakeMyCare), and the Families USA blog, which has been posting weekly about developments.