Supreme Court Ruling to Determine Where the Costs End Up Among Uninsured

The countdown to the Supreme Court decision in King v. Burwell begins. The decision, expected by the end of June, may have huge implications for healthcare players, particularly for insurance companies, hospitals and millions of individual Americans (mostly lower and middle income).

| June 15, 2015

lbeckerdirectory

The countdown to the Supreme Court decision in King v. Burwell begins. The decision, expected by the end of June, may have huge implications for healthcare players, particularly for insurance companies, hospitals and millions of individual Americans (mostly lower and middle income). The "death spiral" that may result from a reversal by the Supreme Court would create opportunities for consultants to work with several interdependent healthcare constituents including payers and providers; and effect the course of treatment for patients.

For those unfamiliar with the case, it in essence comes down to an interpretation of an ACA provision (4 words, "established by the State"), which allows for federally-funded subsidies for individuals to obtain health insurance through HealthCare.gov in states that do not provide a state exchange. The IRS is currently providing these federal tax credits to individuals who purchase through the federally-funded exchanges (as they would if the insurance were purchased through a state exchange). The plaintiffs in the case do not believe that the provision intends for the federal tax credits to apply to those using HealthCare.gov (only state exchanges).

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