Court upholds subsidies in ACA

Tags: texas association of community health centers, affordable care act, health care reform, medicaid, supreme court

Health care organizations and millions of people across the country can breathe a sigh of relief. The Supreme Court has upheld the subsidies established by the Affordable Care Act that help about 6.4 million Americans purchase health insurance on the federal exchange. Had the court struck down those subsidies, more than one million Texans might have lost their coverage.

President Obama addressed the nation from the White House shortly after the ruling was announced, saying there could be no doubt that the ACA is working and that the law is here to stay.

“Today is a victory for hardworking Americans all across this country whose lives will continue to become more secure in a changing economy because of this law,” the president said.

While the ruling comes as welcome news to many, Texas still faces more than its fair share of problems with its health care delivery system. A report written by health care law and policy experts at George Washington University and commissioned by the Texas Association of Community Health Centers and TAFP examines Texas’ decision not to expand Medicaid coverage under the ACA, which leaves more than a million low-income, uninsured Texans without access to Medicaid or to federal subsidies to help them purchase insurance. The report, “How will Texas’ Affordable Care Act Implementation Decisions Affect the Population? A Closer Look,” details the persistent threat of financial catastrophe the uninsured face should they fall ill or suffer an accident requiring significant medical care, as well as the damage done to our local and state economies when hospitals and other providers aren’t paid for care. 

According to the report: “County‐level estimates show that prior to implementation of the ACA, 38 counties experienced hospital annual uncompensated care levels of $50 million or greater, and four counties showed losses greater than $200 million.”

In the recently concluded 84th Texas Legislature, lawmakers made it clear that despite a 9 to 1 federal funding match for expanding Medicaid to all citizens up to 138 percent of the federal poverty level, the expansion of Medicaid under the ACA was “simply not worth discussing.” According to the report, the state would have received an estimated $128 billion in additional federal funding from 2015 to 2024 by deciding to expand Medicaid.

TAFP CEO Tom Banning told the Dallas Morning News the court ruling is good news, but it hasn’t solved “all or even most” of the state’s health care problems. “It just means we dodged one bullet and there are five left in the chamber,” Banning said.

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