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ACA SCOTUS DECISION: WHAT IT MEANS TO YOU

Jun, 26 2015

 Unless you were living under a rock (or just didn’t turn on the TV, listen to the radio, browse the Internet, or talk to another living soul), you’ve probably heard that the Supreme Court finally issued its long-awaited decision yesterday in the King v. Burwell case. 

Click here to review an article posted last week where we discussed this case and the possible ramifications. 

In this update, we just wanted to give a quick overview of the Supreme Court decision and share our thoughts on what it means for you.

The Ruling

It was found that tax credits or subsidies are legal in every state, regardless of whether the state established its own online insurance marketplace or chose instead to use the federal government’s website, Healthcare.gov. If you don’t know, these subsidies help pay for insurance and are available to Americans earning less than 400% of the federal poverty level (about $92,000 per year for a family of 4) who don’t have other options for affordable insurance.

The dissent was written by Justice Antonin Scalia, who strongly disagreed with the Court’s findings, saying that the law, which has twice been upheld by the Supreme Court, should be nicknamed SCOTUScare instead of Obamacare.

With this decision, it now appears more likely than ever that the Affordable Care Act will remain the law of the land. It will certainly be a major campaign issue in the presidential election, but the health reform law isn’t going anywhere anytime soon.

So, how will it affect you? Glad you asked!

Impact on Employers

For employers, this means that the employer mandate will also remain intact. Companies with 50 or more full-time equivalent employees must offer comprehensive and affordable health insurance to their employees or face a penalty. That penalty is triggered when an employee receives a tax credit, so companies in states without an exchange wondered if this case would free them from the employer mandate requirement. That didn’t happen. Mandate or not, health insurance is still a valuable employee benefit, one that workers depend on, so most companies have indicated that they want to hang on to their benefit plans whether required to or not. 

Impact on Employees

If you get your insurance through your employer, this ruling actually has very little impact – workers and their family members who are eligible to enroll in an employer-sponsored health plan aren’t eligible for subsidies. However, because most people know someone without employer-sponsored insurance, there’s really nobody who isn’t affected by this ruling. The subsidies are a cornerstone of the health reform law, and this decision by the Supreme Court means that the law will be around for years to come.

Impact on Individuals

Are you one of the millions of Americans receiving a subsidy to help pay for health insurance? This ruling is a huge victory. The subsidies will continue, which means people will continue to get needed care. However, it’s worth pointing out that all of the ACA required benefits drive up the cost of health insurance, so there’s no end in sight to changes to your plan – like less coverage and more out-of-pocket costs. In short, it will be easier for people to purchase health insurance going forward, but it will become more difficult for people with health insurance to access care. 

It’s a complicated topic, but important to all of us. Do you have questions? Just comment below or email me at eric@freshbenies.com

Eric Johnson

Eric Johnson is the co-founder of ComedyCE.com, a continuing education company designed to make learning fun. He is a broker sales executive for freshbenies, Eric is a nationally recognized speaker and frequent contributor to several industry publications, Eric spends much of this time studying the health reform legislation and translating it into terms that everyone can understand. He can be reached at eric@freshbenies.com.
 

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