The U.S. Supreme Court’s rejection of the latest legal challenge to the Affordable Care Act preserves federal tax subsidies that nearly 70,000 Kansans used this year to help them purchase health insurance.
If the decision released Thursday had gone the other way, those Kansans, many of whom were previously uninsured, might have been forced to drop their coverage.
At issue was whether consumers in Kansas and 33 other states were eligible for tax credits that buy down the cost of their premiums. The court rejected a claim by ACA opponents that wording in the law meant that Congress intended to limit those subsidies to consumers in states that created their own marketplaces.
The 6-3 decision, written by Chief Justice John Roberts, was hailed by ACA supporters and criticized by those still seeking to repeal the law, including members of the Kansas congressional delegation.
U.S. Sen. Pat Roberts, a Republican, said the decision “does not take away from the fact that Obamacare is fundamentally broken.”
U.S. Rep. Tim Huelskamp, a Republican who represents the state’s 1st Congressional District, renewed his call for the ACA’s repeal.
“Without the Supreme Court to bail out Congress, now is the time to act,” Huelskamp said, urging GOP leaders to send a “patient-centered replacement” to President Barack Obama’s desk.
Former Kansas Insurance Commissioner Sandy Praeger, also a Republican but a supporter of the law, had a different take.
“It was the correct decision,” said Praeger, who represented the National Association of Insurance Commissioners when Congress was debating the ACA. Obama signed the ACA into law in March 2010.
If the court had ruled the tax credits illegal in Kansas and the other contested states, “It would have caused chaos in the marketplace,” she said.
Without the subsidies, Praeger said, more than 80 percent of the 85,490 Kansans who have purchased health insurance in the ACA marketplace may have been forced to drop their coverage.
The potential impact would have been even greater in Missouri, where nearly 90 percent of the 219,953 people who purchased ACA plans used the tax credits to lower the cost of their premiums.
Denise Cyzman, executive director of the Kansas Association for the Medically Underserved, the organization that represents the state's safety net clinics, called the decision a "huge victory" for Kansas consumers.
"This decision affirms what we have already known. The ACA works, allowing many Kansans to finally have access to affordable healthcare insurance," Cyzman said.
Current Kansas Insurance Commissioner Ken Selzer issued a guarded statement that his office would “continue working to find ways to make consumer health insurance affordable for Kansans.”
The challenge to the health reform law hinged on whether Congress intended to restrict subsidies to states that established their own marketplaces as a way of encouraging states to do so rather than to rely on the healthcare.gov website operated by the U.S. Department of Health and Human Services.
But Linda Sheppard, the former director of health care policy and analysis at the Kansas Insurance Department with Praeger, said if that was the intent, it was never mentioned in the series of implementation meetings she participated in with federal officials.
“From my personal experience, there was no evidence of that,” said Sheppard, who is now a senior analyst at the Kansas Health Institute, the parent organization of the editorially independent KHI News Service.
In 2011, Kansas was moving toward creating its own marketplace, then more commonly referred to as an exchange. But Republican Gov. Sam Brownback halted those efforts and returned a $31.5 million federal grant that Praeger had obtained to help pay for the exchange.