January 28, 2015
Area(s) of Interest: Access to Care Advocacy Health Care Reform
A new poll has found that nearly six in 10 people believe that Congress or states should act to restore health insurance subsidies if the U.S. Supreme Court strikes them down when it rules on King v. Burwell, a case that questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government.
The poll, conducted by the Kaiser Family Foundation in early January, found that 64 percent wanted Congress to act to make all states eligible for federal aid if the court rules that subsidies should be only available in states with their own markets. Those favoring congressional action included 82 percent of Democrats, 40 percent of Republicans and 63 percent of independents. Fifty-nine percent of those residing in states that use the federal market place said their own state should create its own marketplace if the court invalidates subsidies. The Court has scheduled oral arguments for March 4, 2015, and will release its final decision in June.
The lawsuit has the potential to affect 36 states that use the federal health care exchange, but would not change the subsidies in states like California that run their own exchanges. If the subsidies are struck down, some 5.4 million Americans who signed up for coverage in 2014 through the federal exchange, could be left holding the bag for much higher than anticipated premiums, threatening the future of the ACA in the affected states. California is one of 14 states (and the District of Columbia) that are fully running their own exchanges. The other states rely on the federal government for some or all of their exchange operations.
The poll also found that many of those at risk of losing subsidies aren’t aware of it. Only a third of those in federally run states knew their exchange was run by the federal government, while 39 percent incorrectly thought their state ran its own exchange.
A Rand Corporation study published last month found that of the 5.4 million people who signed up for health insurance on federal-run exchanges last year, 87 percent of them received subsidies. According to the Rand study, without the subsidies, premiums would be 43.3 percent higher on average in the individual market in 2015, while enrollment would drop by 68 percent.
The King v. Burwell case arrived at the Supreme Court after a 4th U.S. Circuit Court of Appeals panel in Virginia in July unanimously ruled in favor of the administration, saying subsidies should be allowed in all 50 states. This case marks the law’s third trip to the high court. In 2012, Chief Justice John Roberts joined four more liberal justices to uphold the constitutionality of the ACA, with four conservative justices dissenting. Earlier this year, Chief Justice Roberts and the four conservative justices carved out an exception to providing contraceptive coverage for employers who object on religious grounds.