When the Affordable Care Act was passed in 2010, leaders of the Marshfield Clinic's Security Health Plan saw an opportunity to offer affordable insurance products to people in its mostly low-income area of central Wisconsin.
Security, a not-for-profit HMO, heavily marketed plans sold through the federal marketplace and helped thousands of Wisconsinites sign up. John Kelly, Security's chief marketing and operations officer, said the 2014 and 2015 enrollment totals “exceeded our expectations.” Security has 34,000 exchange members as of June, making it one of the top exchange plans in the state.
But all of Security's work could be undone this month when the U.S. Supreme Court issues its decision in King v. Burwell on whether the language of the ACA allows premium subsidies in states that did not establish their own exchange. Insurers and consumers in as many at 37 states including Wisconsin could be affected.
If the court rules against the Obama administration, roughly 6.4 million Americans would lose the premium tax credits that make their insurance affordable unless states quickly established their own exchanges, which appears unlikely. In Wisconsin, 91% of 183,000 exchange-plan enrollees who receive subsidies are at risk; the average subsidy in the state is $315 a month. Nationally, the decision would affect 85% of exchange-plan members, who get an average subsidy of $272 a month.