The U.S. Supreme Court on June 25 upheld the Affordable Care Act's premium subsidies in states using the federal insurance exchange.
For more than a year, Modern Healthcare has explored the legal case, the politics surrounding it and how healthcare industry players responded to the threat to subsidies and the ruling.
Roberts opinion means Obama successor can't easily revoke ACA subsidies | June 25, 2015
Insurance premium subsidies will continue to flow to Americans in all states under the Affordable Care Act, the U.S. Supreme Court decided 6-3 in King v. Burwell on Thursday.
Writing for the majority, Chief Justice John Roberts said He wrote the subsidies “are necessary for the federal exchanges to function like their state exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid.”
King ruling dims hopes of crippling the ACA through the courts | June 25, 2015
The U.S. Supreme Court's 6-3 decision Thursday upholding premium subsidies for Americans in all states put to rest months of fretting over the immediate future of the Affordable Care Act. While it didn't necessarily drive a stake through the heart of all anti-Obamacare litigation, legal experts agreed it did send a discouraging message to the law's legal foes.
With subsidies protected, hospital leaders see brighter future | June 25, 2015
Hospital leaders expressed relief and delight Thursday after the U.S. Supreme Court solidified the future of subsidized insurance for low- and middle-income Americans in all 50 states under the Affordable Care Act. “We're just celebrating here today,” said Dr. Richard Gilfillan, CEO of Trinity Health in Livonia, Mich. “In our board meeting, there was just a yahoo, spontaneous shout and glee and then applause.”
Health insurers, consumers breathe sigh of relief after King decision | June 25, 2015
The U.S. Supreme Court's 6-3 ruling to uphold the Affordable Care Act's premium subsidies in all states provided immediate reassurance for health insurance companies and consumers who relied on the subsidies. But the health insurance market under the ACA still faces hurdles and more years of tinkering before the business reaches a true level of stability. Attention now turns toward the premium rates increases for 2016 and beyond.
Is King v. Burwell ruling the end for new or existing state exchanges? | June 25, 2015
The Supreme Court's decision to side with the Obama administration in King v. Burwell could spell the end of states attempting to establish their own exchanges and could even mean some state exchanges could give up control to the federal government. “There is probably minimal incentive at this point to create an exchange from scratch,” said Sabrina Corlette, a lawyer and senior research fellow at Georgetown University's Center on Health Insurance Reforms.
Republicans' new challenge: Replace it with what? | June 25, 2015
In eliminating the last major legal challenge to the Affordable Care Act's insurance subsidies, the U.S. Supreme Court on Thursday raised significant new hurdles for Republicans who continue to make repealing and replacing the law the centerpiece of this year's legislative and next year's political campaign strategies. The outcome narrows Republicans' options to override the law to the crowded campaign trail and Congress, where the Republican-controlled chambers face an assured veto from the president.
Ohio mom worries that court ruling could threaten her family's health insurance | June 19, 2015
Kristen Clark remembers the days when buying health insurance used to be not only complex but also prohibitively expensive. “A lot of times, it's like paying a second mortgage,” she said. The looming U.S. Supreme Court ruling threatening to wipe out premium subsidies in up to 37 states could force Clark and millions of other Americans to experience those days all over again.
HHS approves three state-based exchanges ahead of King decision | June 15, 2015
The Obama administration has given the go-ahead to Arkansas, Delaware and Pennsylvania to switch from federally facilitated health insurance marketplaces to state-based ones.
Loss of ACA subsidies would hurt some insurers more than others | June 12, 2015
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. Nationally, the decision would affect 85% of exchange-plan members, who get an average subsidy of $272 a month. Experts say smaller regional insurers, provider-sponsored plans and some Blue Cross and Blue Shield plans would be jolted. If people lost their tax credits, they would immediately face higher premiums that they likely couldn't afford to pay.
Community health centers brace for more uninsured | June 12, 2015
The nation's 1,200 federally qualified community health centers would be hit hard by a possible U.S. Supreme Court ruling this month eliminating premium subsidies for federal exchange-plan enrollees.
Ruling against subsidies could hit hospital stocks harder than earnings | June 12, 2015
Hospitals and investors are banking on the U.S. Supreme Court or the states to save premium subsidies that have made health insurance affordable for 6.4 million people in 34 states. But the stocks of publicly traded hospital companies could take a big hit if that doesn't happen.
Most states unlikely to create insurance exchanges to save ACA subsidies | June 6, 2015
Don't count on many states to quickly establish their own insurance exchanges to keep their residents covered if the U.S. Supreme Court this month strikes down premium subsidies in states using the federal exchange.
Republicans jockey over post-King reform plans | April 29, 2015
Facing sharp disagreements among themselves, congressional Republicans are nervously wrestling with how to respond if the U.S. Supreme Court in June strikes down premium subsidies in up to 37 states.
Blog: Medicaid 'gun to the head' test depends on which Supreme Court case you consider | March 31, 2015
The U.S. Supreme Court has severely limited the ability of healthcare providers to sue state Medicaid agencies over the adequacy of rates. But in handing down that decision Tuesday, the high court seemed to flatly contradict itself on the power of the feds to tell states how to run their Medicaid programs.There's a similar issue in the pending King v. Burwell case in which the Supreme Court is considering whether to strike down premium subsidies in the nearly three dozen states using the federal insurance exchange.
Blog: Did Justice Kennedy offer a clue to the King v. Burwell decision? | March 24, 2015
No one can read the U.S. Supreme Court justices' minds, so everyone in healthcare is parsing their words for signs of how they'll vote in King v. Burwell. Justice Anthony Kennedy, a potential swing vote in the case, set bloggers abuzz and tweeters a-twitter when he told lawmakers Monday that Supreme Court justices shouldn't take congressional gridlock into account when making decisions.
Blog: Are Republicans, Chief Justice Roberts sweating King doomsday scenario? | March 9, 2015
Even if the U.S. Supreme Court strikes down the healthcare reform law's premium subsidies, Obamacare will live on in many important ways, a recent New York Times article argued. But would it? Given the awful mess such a ruling would create, why wouldn't Congress and the White House instead repeal the entire law and put an end to the hemorrhaging?
Healthcare leaders mull their options as they wait for King ruling | March 7, 2015
Hospitals, health insurers, physician groups and community health centers, fearing financial damage and patient suffering if millions of Americans lose their coverage, are just beginning to sketch out contingency plans in the wake of the oral arguments last week in King v. Burwell.
Premium subsidies case could end federal Medicaid funding in many states | March 6, 2015
Millions of Medicaid beneficiaries could lose their benefits if the Supreme Court rules against the Obama administration in the King v. Burwell premium subsidies case, some legal experts and state Medicaid officials say. On the other hand, the ruling might force states that have reduced Medicaid benefits to restore them.
Blog: Will Chief Justice Roberts let voters decide reform's fate? | March 5, 2015
After Wednesday's oral arguments, it looks like the Supreme Court could go either way in the momentous King v. Burwell case with Chief Justice John Roberts casting the deciding vote. After a century of fierce political debate in the U.S. over national health insurance, the fate of our new, near-universal coverage system almost certainly will be determined by either Roberts or Justice Anthony Kennedy.
Key justices hard to read in King v. Burwell arguments | March 4, 2015
Justice Anthony Kennedy raised the hopes of the Affordable Care Act's supporters Wednesday by expressing doubts about the premise of the latest legal broadside against the law to reach the U.S. Supreme Court. But plenty of other signals suggested the court could rule either way.
Editorial: The economic and political consequences of King v. Burwell | February 28, 2015
A victory for the petitioners in King v. Burwell will not return the healthcare insurance marketplace to the pre-Affordable Care Act status quo. For the 7.5 million people in at least 34 states whose health insurance subsidies are at risk, undermining the federally run exchanges will exacerbate the nation's growing economic inequality.
Actuaries want rates revised if subsidies end | February 28, 2015
Actuaries are pressing HHS to allow health insurers to revise their rates for 2016 coverage if the U.S. Supreme Court invalidates the Affordable Care Act's premium subsidies in federal exchanges. Without leeway to adjust premiums in plans sold in those marketplaces, they warn, the solvency of some insurers “could be threatened.”
Challengers avoid legal standing issue in King subsidies case | February 21, 2015
A new brief filed by those asking the U.S. Supreme Court to strike down the Affordable Care Act's premium subsidies in many states focuses on what they fear are the government's strongest arguments for upholding the subsidies, experts say. It makes no mention of new questions about whether the four individual plaintiffs have legal standing to even bring the case.
Blog: King plaintiffs likely lack legal standing but Supreme Court unlikely to care | February 13, 2015
It isn't exactly surprising that all four individual plaintiffs in the King v. Burwell case have dubious legal standing to pursue their challenge to Obamacare's premium subsidies before the U.S. Supreme Court, as the Wall Street Journal has reported. Similar legal standing questions arose in 2011 about the two individual plaintiffs challenging the constitutionality of the Affordable Care Act in the case that ultimately led to the Supreme Court narrowly upholding the law in 2012.
Americans want Congress to restore subsidies if Supreme Court nixes them | January 28, 2015
Nearly two-thirds of adults want Congress to take action to allow all low- and middle-income Americans to access insurance subsidies if the U.S. Supreme Court strikes down financial assistance in states that don't operate their own exchanges, according to a new Kaiser Family Foundation poll.
Reform law challenge may hinge on Supreme Court's “Chevron doctrine” | November 14, 2014
Experts agree that the justices will have to consider the high court's oft-cited precedent in the 1984 case Chevron USA v. Natural Resources Defense Council in deciding whether to rule in favor of the government or the challengers in King v. Burwell.
Setting up a state exchange not as simple as some think | July 29, 2014
One noted legal expert who supports the Affordable Care Act cautions that it will take a lot more than semantic maneuvers. In a Health Affairs blog post Monday, Washington & Lee University law professor and Obamacare analyst Tim Jost laid out five major steps states will have to take to “establish” their own exchange and enable their residents to keep their federal premium tax credits, if the Halbig ruling is ultimately upheld.
How the high court might rule on exchange subsidies | July 26, 2014
Based on split rulings in the circuit courts, the issue may be headed to the Supreme Court, which could rule by next June—by which time millions of Americans in the 36 states will be receiving substantial premium assistance. Even though the high court often issues decisions involving statutory interpretation, few legal experts would go on record predicting how the majority would rule, particularly given the political polarization around Obamacare.
D.C. appeals court strikes down ACA insurance subsidies for federal exchanges | July 22, 2014
A three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit in Washington has ruled that the text of the reform law clearly forbids income-tax subsidies to go to low- and middle-income Americans who use one of the federally run insurance exchanges. The tax subsidies have been flowing since the beginning of the year, based on a 2012 interpretation of the law by the IRS.
Obamacare legal battle threatens subsidies for millions | June 14, 2014
A legal victory for those challenging the subsidies would achieve a large part of what congressional Republicans have sought but have been unable to achieve legislatively—rolling back and unraveling the Affordable Care Act. That's because most of the 8 million people who signed up for coverage through the exchanges for 2014 qualified for premium tax credits. Taking those subsidies away almost certainly would prompt many of those people to drop coverage.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.
