Waiting on King… what’s at stake?

It feels like déjà vu. The health policy world is waiting on pins and needles to see what the Supreme Court has to say about the viability of the Affordable Care Act. On possible decision days, all browsers are pointed to SCOTUSblog.com. But this time we are waiting for a decision in King v. Burwell to tell us: Will consumers in federal marketplace (FFM) states keep federal financial support to help them purchase coverage? Some call this decision the law’s final test (we hope!).

While we are feeling confident about a good decision, we also want to keep in mind what’s at stake for kids and their families. Here’s a “by the numbers” look at what a SCOTUS ruling for King would mean (based on helpful research by the Urban Institute):

  • 8.2 million: Total number consumers in FFM states that would become uninsured in 2016.
  • 730,000: Number of kids in FFM states that would be come uninsured in 2016.

But wait, there’s more! What about the combined impact of a King decision with a state’s decision not to expand Medicaid (the outcome of the last SCOTUS decision)? FFM states that chose not expand Medicaid will experience the added burden of the decision on top of their politically motivated refusal to cover more low-income adults. In these states in 2016:

  • 9.8 million: Number of additional people added to the ranks of the uninsured in these states (4.2 million from not expanding Medicaid; 5.6 million from loss of marketplace tax credits).
  • $61 billion: Total amount of federal dollars in 2016 states face to lose in 2016 ($40.5 billion in federal funding for Medicaid expansion; $20.7 billion from marketplace spending).

Want more reading on the possible impact in your state while you wait? Some helpful resources (note to number crunchers –  some of the resources below use numbers based on HHS’s marketplace enrollment data; the Urban numbers above are research-based projections for 2016):

 

 

Elisabeth Wright Burak is a Senior Fellow at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.

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