Victory for low-income people in the King v. Burwell decision

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720px-Seal_of_the_United_States_Supreme_Court.svgThe Supreme Court was right to recognize that health reform in the recent decision on King v. Burwell provides tax credits for consumers in all states. Now it’s time for people on both sides of the aisle to accept that the law is working and take important steps to fully implement it. 


The Court made the right decision on the law, which is good for millions of people, including the 170,948 people in South Carolina who have gained coverage through the Affordable Care Act’s federal health insurance marketplace.

  • The Supreme Court found what most experts believed from the beginning: the ACA is clear that subsidies are available in both federal and state exchanges.
  • Millions of people, including 154,221 South Carolinians in , would have lost their subsidies and been at risk of losing their coverage, and insurance markets would have been destabilized had the Court invalidated the subsidies contrary to what Congress intended when it passed the Affordable Care Act.

Now that the Supreme Court has ruled, instead of trying to undermine the law, opponents of health reform in Congress should accept that health reform is here to stay and stop putting forth misguided proposals that would undermine its success.

  • Some in Congress have proposed using a fast-track procedure known as reconciliation to repeal many components of health reform, such as the Medicaid expansion and the marketplace subsidies, without bipartisan support. This would be a bad idea that would leave millions of people uninsured or underinsured.
  • Likewise, Congress should reject harmful, drastic, structural changes to Medicaid, such as a block grant or “per capita cap.” These changes would ultimately leave millions of people uninsured by deeply cutting federal Medicaid funding over time.
  • Proposals to undermine other core elements of health reform, such as repeal of the individual and employer mandates would also undermine health reform and increase costs.

Policymakers should recognize that health reform is working, abandon efforts to undermine it, and instead take advantage of the opportunities that health reform offers to improve lives. The first step should be to expand Medicaid.  

  • States that have expanded Medicaid have seen large gains in the number of adults with health insurance, and they are saving money in their budgets. Hospitals in expansion states are treating fewer uninsured patients, and the amount of “uncompensated care” they are providing is declining steeply.
  • South Carolina has failed to expand Medicaid and has fallen further behind, leaving more than 194,000 people uninsured and without access to affordable health coverage.
  • Nationally, 3.7 million people are uninsured and without access to affordable health coverage because of states’ failure to accept available federal funds for Medicaid coverage for their residents.

In short, the Supreme Court got it right. Policymakers need to accept that health reform is the law of the land and now work to make sure that it succeeds in providing access to affordable coverage for as many people as possible.