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Health Policy in Brief

An RWJF Collection

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Overview of the Potential Effects of a Supreme Court Finding for the Plaintiffs in the Pending King v. Burwell Case

The Supreme Court will announce their finding in the King v. Burwell case on whether or not the government can continue to provide tax credits and cost-sharing reductions to residents of federal marketplace states (i.e., states that did not create their own insurance marketplace).

The Issue

If the Court finds for King, the effects would be far-reaching and would put residents of at least 34 states at risk of losing financial assistance to purchase private nongroup insurance coverage under the Affordable Care Act.

Key Findings

  • In 2016, the number of uninsured people would be 8.2 million higher than it otherwise would have been.

  • The size of the private nongroup insurance markets in the affected states would drop by about 70 percent due to the loss of financial assistance.

  • Spending on behalf of those becoming uninsured would fall by 35 percent.

  • Of those becoming uninsured, three-fourths are low or middle income, but are not poor; over 60 percent are white, non-Hispanic; and over 60 percent live in the south.

Conclusion

The authors note if the Court finds for King, considerable uncertainty is likely to remain as to what will be required of a state in order to be deemed to have established its own marketplace.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. For more information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research, visit http://www.urban.org/policy-centers/health-policy-center.

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