The case before the U.S. Supreme Court that might have put millions of Americans at risk of losing their access to health insurance has instead turned into a resounding win for the Obama administration. In the case of King v. Burwell, the justices voted 6-3 in favor of upholding the subsidies that those in states not running their own exchanges receive from the federal government.
The challenge was brought before the court initially over a small clause in the Patient Protection and Affordable Care Act that seemed to specify that only those in states that set up their own health insurance marketplaces would be eligible to receive federal subsidies to help them cover the cost of those policies, according to a report from NBC News. However, the issue at hand amounted to four words in a document of well over 1,000 pages
Therefore proponents including President Barack Obama believed that a ruling against the broader access to subsidies would have been against the clear and overwhelming spirit of the law, even if the four words in question were a concern, the report said. Indeed, the court's majority opinion stated that, "If at all possible, we must interpret the Act in a way that is consistent with [improving the national health insurance exchanges], and avoids [dismantling them]."
Big concerns for consumers
If the subsidies had been struck down by the Supreme Court, health insurance experts believed this would have posed major issues for the industry as a whole, the report said. Currently, about 6 million Americans receive subsidies through the federal Healthcare.gov marketplace, and those help to cover an average of 72 percent of their premiums (roughly $270 per month per plan). All those people would have lost their access to the subsidies, leaving only the residents of the 16 states that set up their own exchanges getting financial assistance.
And companies too
That would have been harmful not only to those Americans, but also to health insurers and care providers, the report said. That's because the vast majority of those consumers - who tend to have far lower incomes than the national median - likely would have ended up just going without coverage (which means the loss of millions of policyholders for insurers) but would probably seek health care when necessary anyway, meaning a greater risk of not receiving payment for hospitals and doctors.
In fact, there was such a great concern about the decision among the health insurance and health care industries that experts were predicting chaos if the subsidies were struck down, the report said. Tal Gross, a health policy expert at Columbia University's school of public health, told the newspaper that these industries "did dodge a bullet" in getting a favorable ruling.
With this issue settled, insurers can now devote their attentions to making other positive changes that could help to attract more consumers in the months and years to come. With the assurance of subsidies being available more or less in perpetuity, there should be no issues in continuing to attract people who have previously had limited access to coverage.