Insurers, Hospitals Brace for Affordable Care Act Ruling


Hospitals, doctors and consumers are preparing for the fallout if the Supreme Court strikes down subsidies that help about 6.4 million Americans buy health insurance under the Affordable Care Act.

Some people are making medical appointments now, in anticipation of being unable to afford their insurance. Hospitals are exploring ways to increase charity care or planning their lobbying strategies should subsidies on the federal insurance exchange be found illegal. And doctors worry about what they would tell their patients.

Alice Chen, a physician and assistant clinical professor at University of California, Los Angeles, said she and other doctors are weighing how to explain to patients other medical resources, such a charity clinics, if they can no longer afford insurance.

“We’re certainly thinking of what to do,” said Dr. Chen, who is executive director of Doctors for America, a group of physicians and medical students working to improve health care. “Many patients are very out of the loop on what’s happening.”

The lawsuit, which the Supreme Court is expected to decide this month, seeks to halt subsidies that offset the cost of insurance for people in some three dozen states that use the federal insurance exchange,, to buy policies. Plaintiffs in the case, King v. Burwell, say language in the health law allows the tax credits only for residents in states that operate their own exchange.

Health-care experts say the industry would be rattled by the loss of billions of dollars in subsidies. Such a move would send insurance prices soaring for those who currently get the tax credits, and raise the number of uninsured Americans—posing financial perils for many hospitals and insurers.

According to the Centers for Medicare and Medicaid Services, the nearly 6.4 million consumers who use the federal exchange received an average subsidy of $272 a month.

Ascension Health, the nation’s largest Catholic and nonprofit health system, is preparing its lobbying strategy should subsidies be eliminated. The Missouri-based organization plans to press national and state lawmakers to back proposals to extend subsidies, and it won’t support ending the law’s requirements that all Americans have health insurance and that larger employers provide affordable coverage to workers.

“We’re going to directly communicate with legislators and encourage the American Hospital Association to do the same,” said Peter Leibold, chief advocacy officer for Ascension Health.

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Source: Wall Street Journal