SCOTUS Decision On Affordable Care Act Could Affect Hoosiers

The U.S. Supreme Court will hear oral arguments in King vs. Burwell Wednesday. It’s a case that challenges one of the main components of the Affordable Care Act. The outcome could affect hundreds of thousands of Hoosiers.

People like to compare the Affordable Care Act to a stool with three legs. The first leg mandates that insurers can’t discriminate against potential buyers; the second leg requires people to have insurance; and the third provides those who don’t have enough money to buy insurance subsidies so they can afford it.

It’s that third provision — the subsidies — that’s up for review. The plaintiffs argue because of the law’s wording, only people living in states with their own health-care exchanges are allowed to receive money from the government to fund their insurance. People in states without their own marketplaces — including Indiana — aren’t entitled to subsidies, they argue.

David Orentlicher, a professor and co-director of the Hall Center for Law and Health in Indianapolis, says if the Supreme Court sides with the plaintiffs, the entire federal marketplace could collapse.

"If the challengers’ argument is accepted and the court says ‘no subsidies in states with federally-run exchanges,’ then the three-legged stool falls down,” Orentlicher said.

Orenthlicher says he doesn’t see that happening, though. After all, the phrase in question comprises four words in a 900-page document favoring federal assistance.

"Even if you buy the argument that there’s no ambiguity, we’re stuck with the statutory language," Orentlicher said "The court's not going to adopt an interpretation that goes against the purpose of the act that unravels the act rather than promotes the act.”

According to estimates, more than 200,000 Hoosiers receive subsidies tallying more than $1 billion under the Affordable Care Act.