A recent U.S. Supreme Court decision to hear a challenge to the Affordable Care Act raises new questions as 2015 enrollment gears up. The challenge involves the 34 states that refused to set up their own exchanges for offering subsidies, including North and South Carolina.
Most rulings from lower courts have sided with those who say the federal exchange those states use is valid, but the review raises the prospect that it could be deemed illegal. There's a lot at stake: The first time around, more than 325,000 North Carolinians got tax credits to reduce the cost of health insurance.
“Is there a guarantee that the subsidy won’t be revoked by the Supreme Court and you’ll be stuck having to pay the bill yourself?” a blog reader asked earlier this week. “... Would they have to pay for the rest of the year without a subsidy? For the previous parts of the year?”
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| Brandon |
The consensus seems to be that there's no risk to signing up. Asking people to repay assistance would be unheard of, two experts I spoke with said. A ruling would be unlikely before summer, and both Washington and Lee's Timothy Jost and UNC Charlotte's William Brandon say it's doubtful that the court would leave millions of Americans suddenly stranded without the aid they're counting on.
“People should go ahead and sign up, and the Supreme Court will hopefully go the right way,” said Jost, a law professor who's the author of a health law casebook. “Why would (Congress) have created the federal exchange if it can’t do anything?”
Brandon, a professor of political science and health policy, agrees: “People would be making a big mistake if they hold off on enrollment thinking it may not be there next year.”
An enrollment Q&A by Margot Sanger-Katz of The New York Times reached the same conclusion: "Ultimately, the case could mean that people in those states (using the federal exchange) who are getting subsidies to help pay for health insurance will no longer be able to receive them. But the case is a long way from being decided and won’t take money away from people who sign up for insurance now."
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| LaWana Mayfield |
At an enrollment kickoff Wednesday, Charlotte City Council member LaWana Mayfield talked about "fear tactics" being used to deter the people who are most likely to lack health insurance -- young people, African Americans and Latinos -- from signing up. She said people are "being told it will be taken away."
One thing seems certain: The political strife over "Obamacare," approved in 2010 with no Republican votes, will rage on in 2015, as the GOP gains a majority in the Senate as well as the House.