King v Burwell in NC

burwell.jpgIf you haven’t already, you will likely be hearing a great deal about the possible effects of King v Burwell, the Supreme Court challenge to the Affordable Care Act that is likely to be handed down next week, as early as Monday Thursday morning. There are lots and lots of people saying lots and lots of things about the case, but we wanted to break things down a bit for you to see what the impact would be here in North Carolina.

While a finding for the Plaintiffs in the case would not destroy the Affordable Care Act as many have carelessly opined, this court decision does have the potential to significantly upend the health care system overall, and portions of the ACA in particular. In North Carolina alone, more than 492,000 people have coverage through its federal marketplace, and 93 percent of those enrollees have received financial assistance, and those folks would be directly impacted, almost right way. 

If the U.S. Supreme Court were to rule in favor of the plaintiffs in the King v. Burwell case, more than 400,000 North Carolinians would likely lose their insurance. According to the Urban Institute, 407,000 North Carolinians would be unable to afford their health insurance coverage and would become uninsured if the U.S. Supreme Court repeals the tax credits available under the Affordable Care Act in the federal marketplaces. More than 450,000 North Carolinians would lose an average of $3,792 in tax credits.

In addition, nearly 460,000 North Carolinians would lose an average of $3,792 in tax credits. According to the Centers for Medicare and Medicaid Services, 458,738 people would lose an average of $3,792 in tax credits if the U.S. Supreme Court rules in favor of the plaintiffs.

On average, insurance premiums would increase more than 330 percent in North Carolina. According to the Kaiser Family Foundation, the average subsidized enrollee in North Carolina would face a premium increase of 336 percent. This estimate does not take into account the significant premium increases expected in 2016 and beyond if the elimination of premium tax credits causes healthy enrollees to drop coverage.

Needless to say, this is an incredibly important decision that will impact almost every person with health insurance in North Carolina. The NC Commissioner of Insurance, Wayne Goodwin, has warned that if Burwell is endorsed by the Court, the insurance marketplace in the state will see significant disruption.

Unfortunately, there isn’t much we can do, except to wait and see what the Supreme Court decides. If you’re looking for predictions, I think the vote will go 6-3 to uphold the ACA and against the plaintiffs. But really, it’s anybody’s guess.

Isn’t democracy fun?