The Affordable Care Act, commonly referred to Obamacare, is no stranger to litigation, but the US Supreme Court this week is set to make a decision that could fundamentally change the contentious health-care law.
King v Burwell raises the question as to whether states that have the federal government run the health insurance exchange marketplace are eligible for subsidies that help people afford insurance.
A decision from the court is expected to be handed down any day and it is unclear how the justices will rule.
So what would happen if the Supreme Court rules against the Obama administration?
Millions of people would lose their subsidies
Some 6.4 million people could lose their health insurance subsidies — and possibly their ability to afford insurance — if the high court rules that the 34 states that use the federal exchange are ineligible for those subsidies, the New York Times reported.
More than 100,000 others could lose subsidies in Oregon, Nevada and New Mexico, as those states planned to run their own insurance exchanges, but now use the federal system.
Those without subsidies may have to pay more for health insurance
A decision against the Obama administration will impact more than just the people who receive subsidies — a threshold set at 138 per cent of the poverty level. If older and unhealthier people join the general insurance pool, rates will likely rise.
Decision could create a huge gap between states with subsidies and states without
The Urban Institute estimated that if the Supreme Court cans subsidies for states that do not have their own exchanges, those states will have nearly double the number of uninsured people.
By 2016, the Urban Institute estimates that 15 per cent of people will be uninsured in states that would lose subsides, while just 8 per cent of people would be uninsured in states that would keep subsidies.
Cutting the number of uninsured people was the primary goal of the Affordable Care Act. If the Urban Institute’s forecast were to be realized, it would deal a massive blow to the Obama administration.
$137 billion more to deficit over decade: that's what non-partisan Congressional Budget Office says would happen if Obamacare repealedhyphen; West Wing Reports (@WestWingReport) June 22, 2015
Follow @PaytonGuion on Twitter.