By Jen Rini
A critical ruling by the U.S. Supreme Court on Thursday saved more than 19,000 Delawareans from potentially losing their health coverage.
By a vote of 6-3, the court ruled the government subsidies that made Obamacare affordable for millions are valid through all Obamacare marketplaces, not just those run exclusively by the states.
"I am pleased that those individuals do not have to be worried about the uncertainly about that financial assistance," Delaware Health Secretary Rita Landgraf said hours after the court's decision.
"This decision further affirms the importance of access to health care ..."
The case, King v. Burwell, questioned a statute in the Affordable Care Act (ACA) that describes who is eligible for government subsidies on health plans offered through Obamacare marketplaces. The plaintiffs argued the written language of the law allows subsidies – in the form of tax credits – only for people who get their insurance through a marketplace "established by the state," not marketplaces working with the federal government.
Delaware, along with seven other states, has a state-federal partnership, which acts as a hybrid. The feds provide the technology, while Delaware does the outreach. If the court had ruled in favor of the plaintiffs, 85.4 percent of the 22,397 Delawareans who receive subsidies may not have been able to afford coverage. Their average tax credit is $265.
"I'm incredibly excited that the Supreme Court got it right," said Donald Morton, pastor of Perfected Life Church, who helped enroll hundreds of Delawareans in insurance plans as a marketplace guide with Brandywine Women's Health Associates.
Though he has an Obamacare plan, Morton wasn't eligible for the subsidies himself. But, he said, he saw many who rely on those tax credits to help them make important health care decisions.
Morton was without health insurance for 30 years and immediately saw the benefit. At one of his first doctor's appointments, he got a cancer diagnosis.
"I wouldn't be alive if I wasn't able to go to the doctor," Morton said. "I'm eternally grateful."
It is indisputable that the authors of the ACA intended for Americans in every state to have access to health insurance tax credits, U.S. Sen. Chris Coons, D-Del., said in a statement.
"Today's Supreme Court decision is a victory for millions of middle-class and low-income Americans who will continue to have access to affordable health insurance," Coons said.
Added, senior Sen. Tom Carper, D-Del., "I hope we can now move forward together to improve the ACA and strengthen our country's health care system."
Chief Justice John Roberts wrote in the majority opinion that, "Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them."
Roberts' response was the biggest surprise to John Culhane, law professor and co-director of the Family Health Law and Policy Institute at Widener University.
The health law could have been written better, Culhane said, but the intent was not to make it more difficult for people to get insurance. The intricacies of the Affordable Care Act should be worked out in the political process, he added, not the courts.
"You could say it's a victory for the Obama administration, but really it's a victory for people who now have insurance," Culhane said.
The agent and broker community is relieved that the subsidies are no longer in jeopardy, Nick Moriello, president and chief executive officer of Health Insurance Associates brokerage firm in Newark, said in an email.
"Now, federal focus can shift to legislation to make healthcare reform more workable for individuals and businesses," he said.
Delaware and 33 other states who are in partnership with the federal government to offer health insurance on the marketplace had been watching for weeks to see how the high court would interpret the rule.
If the court had ruled in favor of the plaintiffs, millions of people would have had their tax credits taken away, forcing them to make a decision of whether or not to keep their health plans.
In anticipation of that, Delaware officials filed and won a "conditional approval" from the feds to form a state-run Obamacare marketplace so Delawareans who received subsidies could still keep them.
Even though the move is no longer necessary, the state is still evaluating whether it would be best for Delawareans, Landgraf said. The cost could be prohibitive, especially on the tech side and the cost the state would have to bear.
"The last thing Delaware wanted to do is add more cost to the premiums and co-pays in order to sustain an information technology platform," she said.
She anticipates the state to make a decision by July.