King v. Everyone

The U.S. Supreme Court’s June 25^th decision in King v. Burwell to maintain the premium subsidies created by the Affordable Care Act (ACA) is viewed very differently across our state.

Some Utahns described the King decision negatively.

Sen. Orrin Hatch (R-UT) issued a press release stating: “Obamacare has been a series of broken promises from the start. From skyrocketing costs to less access to care and more bureaucratic control of the healthcare system, the President’s law has failed patients and taxpayers.”

Utah House Speaker Greg Hughes reacted this way: “This administration’s damaging healthcare policy continues to undermine real insurance markets and drive up the cost of healthcare, resulting in less access to care for many of our nation’s most needy.”

Meanwhile, Salt Lake City business owner and cancer survivor Victor Saldivar said he was “extremely relieved” by the court’s decision to keep the subsidies. “Without the subsidy, I am not sure what I was going to do. I was thinking of moving out of my apartment and go live in my car to afford coverage.”

And Lisa Patterson of Moab responded to the news by saying, “Oh yes, yes, that is such good news. I feel like I’m going to cry.” Sonja Blackham, who receives a premium subsidy to purchase health insurance for herself and her husband, reacted to the decision by saying, “I think it was the right decision and a good thing. I feel like there’s no going back now… I don’t think they can just take it away now.”

So which is true for Utah?

Are the ACA’s premium subsidies “overwhelmingly harmful to the U.S. healthcare system,” as Rep. Chris Stewart claims? Or do they help real Utahns like Victor, Lisa, and Sonja stay insured and healthy?

We think you know where UHPP comes down on this issue.

Our West Valley City office is a focal point for the Take Care Utah enrollment network, which gives us an up-close perspective on how access to affordable health insurance can improve the financial and health security of Utah families. We recognize that some individuals and businesses believe that the ACA is negatively impacting their choices or their bottom-line. But when we investigate many of those stories, we learn that the blame for their troubles should be placed elsewhere.

We also know that last month’s Supreme Court decision was about a lot more than just premium subsidies. It was about maintaining the trajectory of improving access to affordable and quality health insurance in Utah and across the country. And those goals matter to everyone. As a result, we’ve put together these five reasons why the King v. Burwell decision matters to many more Utahns than the 86,000 who depend on the subsidies for their coverage.

Here’s our list.

(1) Utahns will be able to keep their health insurance.

This one is easy. The 86,000 Utahns who currently receive premium subsidies will keep their insurance coverage. They will continue to be able to see their doctor, receive treatments, access prescription drugs, and get preventive care and check-ups.  As of March 31 over 128,220 Utahans have signed up for health insurance through healthcare.gov, and over two-thirds receive subsidies—worth an average of $208 a month—to make their coverage more affordable. In addition, Utah has the nation’s highest percentage of children and young adults enrolled in ACA insurance in the nation. 22% of all ACA sign-ups in Utah are by kids under age 18.

(2) More Utahns will be able to sign up when they need health insurance.

Anyone who loses their insurance coverage due to job loss, divorce, or moving to a new place can sign up for health insurance to maintain continuous and affordable coverage. Plus, parents with new babies can sign up their newborn and their entire family for new insurance. Had the subsidies gone away, any Utahn who needed new insurance would have been stuck without affordable options.

(3) The rest of the insurance marketplace will be more stable and efficient.

Since all of the marketplace (ie. ACA) insurance is sold by the same private insurers that offer other individual and small-group policies, any disruption to the premium subsidies would have hurt those insurers. This means that the 60% of Utahns covered by employer-based insurance will experience fewer disruptions, rate increases, and benefit cutbacks because the ACA subsidies are intact. Had the subsidies been taken away, Utah insurance companies and the Congressional Budget Office had warned that the resulting turmoil would have increased costs and cutbacks for the entire insurance marketplace.

(4) The legislature and governor can continue to work on a solution to Utah's coverage gap.

On the last day of the 2015 legislative session in March, lawmakers passed a bill to create the so-called “Gang of Six,” a special group of policymakers tasked to negotiate a solution to Utah’s coverage gap by a July 31 deadline. Written into the bill was the suggestion that the upcoming King v. Burwell decision would factor into their decision-making process.  Now that we know the premium subsidies are intact, the Gang of Six can negotiate a coverage gap solution based on the reality of ACA insurance being available to Utahns who earn enough to stay out of the gap.

(5) Even if you don't receive subsidies, the decision preserves the ACA so that it will remain available in case you need them in the future.

Although 62% of Americans support the Supreme Court decision to maintain premium subsidies, the same poll shows that the percentage of people with a “favorable” opinion of the Affordable Care Act is still below 50%. We can explain this discrepancy two ways. First, acceptance of the ACA is still hamstrung by widespread misinformation. Second, only about 10% to 15% of Americans directly benefit from ACA insurance at any time. But here’s the silver lining.  Even if you don’t need ACA insurance now, you or a close family member might need it in the future when you 1) retire early, 2) lose your job, 3) move to a new state, or 4) start your own company. Plus, you’re already benefiting from the ACA if you have a pre-existing health condition, are insuring a young adult under age 26, are age 40 or above, or receive Medicare. Many people just don’t realize those new benefits are because of the ACA.  Over the long-term, we see the ACA becoming more like the G.I. Bill, the landmark legislation first passed by Congress in the 1940s to give returning service members access to low-cost mortgages, loans, and tuition assistance. Not everyone benefited from the G.I. Bill, but our society deemed it as a public policy worth supporting because of its overall impact on our workforce, family structure, and economy. The ACA does many of the same things for a specific portion of our society, and we believe its benefits will also be recognized and supported.