Supreme Court rules in favor of ACA subsidies

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

The Supreme Court ruled 6-3 on Thursday that subsidies provided under the Affordable Care Act are legal in every state, regardless of whether they come from state healthcare exchanges or Healthcare.gov.

Thursday's ruling brought praise from long-term healthcare industry leaders, who say it's a step in the right direction towards providing healthcare for people of all ages.

“The ACA has positively impacted the field of aging services by allowing providers to create innovative, community-based approaches to help seniors stay as independent and healthy for as long as possible,” said LeadingAge President Larry Minnix.

The main point of contention in King v. Burwell was unclear language in the ACA, which opponents said limited subsidies to consumers who purchased coverage through state-established exchanges. Analysts predicted that a ruling against federal subsidies would cause insurance prices to skyrocket, and leave nearly 8 million Americans without coverage. The Supreme Court's ruling should bring relief to both Obamacare supporters and critics, according to National Center for Policy Analysts Senior Fellow John Graham.

“We will never know what they were going to do in Congress if King had prevailed,” Graham told McKnight's. “Those of us who oppose Obamacare may be relieved by that, that we did not see what Congress was going to propose, because it did not look to me like they were ready.”

Despite a perception that the ruling wouldn't have an impact on Medicare-eligible seniors, BDO Consulting Managing Director Bill Bithoney, M.D., said the decision should ease any concerns elderly consumers had about changes to their coverage.

“I've talked to people in their 80s recently about it, just doing my own informal survey, and a number of them were sure that it would mean catastrophic changes for them,” Bithoney told McKnight's. “This will certainly help calm seniors who have been confused.”

The Center for Medicare Advocacy also applauded the decision, with Executive Director Judith Stein calling it a victory “for our health coverage as a whole, including Medicare.”

“In addition to expanding health insurance coverage to millions of people who previously went without it, the Affordable Care Act strengthened and improved the Medicare program in a number of ways,” she said. “It is time for the assault on the ACA to end, and for policymakers to support affordable health coverage for all.”

The King v. Burwell ruling may usher in the end of state-based exchanges now that federal subsidies have been deemed legal, Graham also said.

“Other than Connecticut, we're not really seeing very successful state-based exchanges, and they have to pay the operating costs themselves now so the states are struggling to figure out how to raise the money to pay for the operations,” Graham said. “Over the next year or two you'll see those 16 states [who still have state-based exchanges], they'll start saying ‘You know what - we'll just go into healthcare.gov.'”