With a soft spot for health care reform, we sidelined our plans to promote Men’s Health Month to instead promote another historic decision by the Supreme Court of the United States (SCOTUS) in favor of the Patient Protection and Affordable Care Act (ACA).
Its June 25, 2015 King v. Burwell decision effectively preserves benefits for the 6.4 million Americans with coverage through the health insurance marketplace and the countless additional Americans who will purchase insurance through the marketplace in years to come. The Court’s 6-3 vote confirms that consumers in every state have equal access to federal subsidies to purchase health insurance whether their state’s marketplace is operated by the federal government or by their state. Currently, 27 states default to the federal marketplace (with residents applying for coverage through healthcare.gov), 17 states (including the District of Columbia) operate their own marketplaces (with three using the federal IT platform), and the remaining seven using a hybrid federal-state model.
Essentially, the administration’s original vision for each state to run its own marketplace didn’t exactly go as planned, sparking arguments from critics about the constitutionality of the federal tax subsidies that have enabled millions of Americans to purchase insurance (many for the first time). While the law that established the ACA does state fairly clearly that subsidies were intended for those on “an exchange established by the state,” it has not been enforced as such, as consumers from all states–regardless of the type of marketplace–have had access to such subsidies. Critics argued that the subsidies should be limited to those in the 17 states (and District of Columbia) with state-run marketplaces per the wording of the law. Nevertheless, in its second major opinion in favor of the ACA, SCOTUS reaffirmed the broader intention of the Affordable Care Act in providing health insurance coverage to as many Americans as possible. Well done.