A blizzard in late June? Is it even possible? Yes, and I’m afraid it will only continue…
Late this month, the Supreme Court is expected to issue their decision on King v. Burwell – a highly charged case that challenges the legality of health insurance subsidies to low- and middle-income people enrolled in federally-based exchanges or marketplaces.
More specifically, if these people live in Iowa and 33 other states where the federal government operates the health insurance marketplace, future subsidies will be at risk.
If the Supreme Court rules in favor of those challenging this critical piece of the Affordable Care Act (ACA), how would subsidized Iowans be affected? Thanks to a newly released Kaiser Family Foundation interactive map, we can view 2015 enrollment data (Source: U.S. Department of Health and Human Services) that is broken out by each state’s marketplace.
The Kaiser map looks at the total number of residents in each state that would lose premium assistance, and the total dollars in subsidies that would be lost. In addition, should the Supreme Court nullify the subsidies provided through the federal marketplaces only, this interactive map shows the size of the lost subsidy for the average resident and the potential increase to their premiums.
On a national basis, about 6.4 million Americans could lose subsidized coverage, worth about $20.4 billion annually. Those who currently receive subsidies for their health insurance coverage would see an average premium increase of 287 percent if they were to pay the full cost of coverage.
Based on the 2015 enrollment – if federal marketplaces are not allowed to provide subsidies – here’s what it would mean for Iowa:
- 34,172 Iowans would lose tax credits. (Iowa would rank 27th compared to other states in terms of people losing subsidies.)
- Total monthly tax credit dollars at risk: $8,987,236 (Iowa ranks 8th lowest when compared to other states.)
- Average tax credit per Iowa enrollee: $263 (Iowa ranks 20th highest, with the national average being $273.)
- Percent increase in average premium: 244% (Iowa ranks 20th highest, with the national average being 287%)
Many more Iowans qualify to receive subsidized premiums in the Iowa marketplace but have elected to remain outside this exchange. In fact, based on an earlier Kaiser Foundation report, Iowa ranks second among other states with having the lowest percentage of its population enrolled in the public marketplace. A May 11th Des Moines Register article suggests that just 20 percent of Iowans who could have qualified for premium subsidies in 2014, took advantage of them.
The upcoming Supreme Court ruling has a multitude of implications in Iowa and around the country. Political and legal uncertainties continue to cause a seemingly unending blizzard in our healthcare snow globe. It’s never too early to prep your snowblower!
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