If the Supreme Court sides with the plaintiffs in the King v Burwell case, low- and middle-income workers will be hit hardest, according to an Urban Institute and Robert Wood Johnson Foundation report.
The report estimates that 9.3 million Americans will lose tax credits if the Supreme Court rules that the Affordable Care Act (ACA) insurance subsidies offered on Healthcare.gov violate the law. All told, this will cause about 8.2 million people to lose their insurance; the bulk of them, nearly 6.3 million, have purchased non-group insurance with these tax credits.
It's this group that will be hit hardest. More than four in five are low-income (making between 138 and 200 percent of the federal poverty level annually) or middle-income (between 200 and 400 percent) and not poor. The vast majority work either part time (35 percent) or full time (46 percent). Nearly 60 percent reside in the South, and about half have a high school education or less.
Removing 6.3 million people from the insurance market will have far-reaching effects, driving up all premiums in the non-group insurance market by at least 35 percent at a time when out-of-pocket healthcare costs are too high. That's why the Rand Corp., in a previous study consistent with the Urban Institute findings, has said ACA subsidies are "essential" to the individual market.
The Supreme Court will hear King v Burwell on March 4 and issue a ruling in June. In the meantime, more that 700 pieces of legislation have been filed at the state level to either challenge or expand the ACA, according to the Center for Public Integrity. That number would rise dramatically if the Supreme Court deems the ACA subsidies on the federal exchange illegal.
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