Consumers in Kansas and Missouri are among those who could be most affected if the U.S. Supreme Court eliminates federal subsidies in states that didn’t set up their own health insurance marketplaces.
The court announced on Monday that it will hear arguments in the case — King v. Burwell — on March 4, 2015.
At issue is whether the Affordable Care Act authorizes federal subsidies only in state-operated marketplaces and not in the federal marketplace being used by consumers in Kansas, Missouri and up to 35 other states.
Opponents of the law point to language that suggests Congress intended to restrict subsidies to states that set up their own marketplaces. The law’s supporters maintain the restrictive language is a drafting mistake and that other parts of the law make it clear that Congress intended for all eligible consumers to have access to subsidies.
Nationally, more than 13 million Americans could lose their coverage if the court eliminates subsidies in federal marketplace states. In Kansas, nearly 80 percent of the 57,013 people who purchased coverage in the first ACA enrollment period would lose their subsidies as would 85 percent of the 152,335 Missouri consumers who used them to help purchase coverage, according to the Department of Health and Human Services.
Sheldon Weisgrau, director of a foundation-funded effort to educate Kansas consumers and policymakers about the ACA, says a court decision to allow subsidies in only those states that run their own marketplaces could be “devastating for tens of thousands of residents of Kansas and Missouri” who need financial assistance to purchase health coverage.
“Most will no longer be able to afford health insurance and will once again face the health and financial consequences of being uninsured,” Weisgrau says.
“The insurance market could be destabilized, endangering the financial health of insurance companies and coverage of those who don’t rely on the federal exchange,” he adds.
Kansas Republican Attorney General Derek Schmidt sides with ACA opponents who contend the law restricts subsidies to the 18 states that established their own marketplaces, also known as exchanges. He and other state attorneys general intervened in the King case and in another challenge to Internal Revenue Service rules that allowed subsidies in federal marketplace states.
“Congress might not have expected so many states to decline to establish an exchange under the Affordable Care Act, but that misjudgment cannot justify allowing the IRS to effectively rewrite the statute to satisfy policy and political objectives, ” Schmidt said in a July news release.
A conservative group called The Missouri Liberty Project, based in Columbia, Mo., and headed by a former law clerk for Chief Justice John Roberts, has filed a friend-of-the-court brief in the case. The brief urges the court to side with opponents of the law.
Jim McLean is executive editor of KHI News Service in Topeka, a partner in the Heartland Health Monitor team.
