Providers ponder prospect of Supreme Court killing Obamacare

Supreme Court to rule on whether providers can sue states over inadequate Medicaid rates
Supreme Court to rule on whether providers can sue states over inadequate Medicaid rates

Individuals struggling to make ends meet and long-term care providers relying on a solvent Medicaid program could be on opposite ends of the verdict when the U.S. Supreme Court begins deliberations on a lawsuit trying to kill the Affordable Care Act.

At the heart of the King v. Burwell case are the subsidies about 9 million Americans are getting from enrolling for health insurance through HealthCare.gov, according to recent reports. Plaintiffs claim the subsidies are illegal. If the high court agrees, many experts believe the consequences would be fatal for the healthcare reform program.

Deliberations begin next week and a decision is expected as early as June.

Notably at risk:

• Most of the 11.6 million individuals who applied for health insurance this year did so through HealthCare.gov. A decision against the government could force them to return the subsidies the government agreed to provide so they could afford health insurance.

• Republicans running for office in 2016 who supported the effort to abolish Obamacare. Twenty-two of the 24 GOP senators running for new terms next year are from HealthCare.gov-supported states. Some Republicans have hinted they would support a temporary measure that would ease the loss of those subsidies.

While it's unclear what impact the end of Obamacare would have on long-term providers, it likely would close the spigot on the flood of new enrollees fueling a massive expansion in the Medicaid program.

The ACA rollout has been marred by an ongoing series of blunders and missteps, beginning with a bungled initial rollout two years ago, data inaccuracies, and confusing program requirements and tax information. Some smaller long-term care providers also have balked at being forced to offer health insurance or face stiff penalties.

HealthCare.gov operates in the 37 states that have opted not to establish their own marketplaces, and most of the 11 million people who enrolled for Obamacare coverage this year live in those states. People in those plans typically are given subsidies by the government so they can afford health insurance. Republican lawmakers supporting the suit claim the government is subsidizing healthcare.gov enrollees illegally because the subsidies, or tax credits, they are given should be coming from the individual marketplaces established in the other 13 states.