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Court: Florida Can Keep HealthCare.gov Subsidies

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U.S. Supreme Court

Today’s U.S. Supreme Court decision on health subsidies keeps intact the way more than 1 million Floridians buy and pay for insurance through HealthCare.gov.

The justices said in a 6-3 ruling Thursday that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.

The case, King v. Burwell, was deciding whether low- and moderate-income Floridians and residents in 36 other states can get tax credits for plans they buy through the federal government.

The Supreme Court’s decision to uphold the nationwide tax subsidies under President Barack Obama's health care overhaul is the second major victory for Obama in politically charged Supreme Court tests of his most significant domestic achievement.

Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold the law in 2012.

Justice Anthony Kennedy also voted with his more liberal colleagues.

An estimated 94 percent of the 1.4 million Floridians who buy insurance this way receive some sort of financial subsidy to help pay for a monthly insurance premium.

The number of residents affected in Florida is far more than any other state. The second highest enrollment on HealthCare.gov is in Texas, where 966,000 residents have purchased plans.

Advocacy groups across Florida quickly responded to the decision.

“The Affordable Care Act is working as intended, and today’s decision should finally put an end to efforts to hijack or derail this historic and law that is saving lives,” said Leah Barber-Heinz, CEO of Florida CHAIN.

Karen Basha Egozi is CEO of the Epilepsy Foundation of Florida, one of several groups hired to help enroll Floridians on the marketplace the past two years.

“Our Navigators have seen how much Florida's families benefit from affordable health coverage, she said in a statement. “Today's Supreme Court decision will allow those families, and eight million more across America, to continue getting the healthcare they deserve."

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Barber-Heinz also renewed the call to expand Medicaid in Florida, something that has failed in the three previous Legislative sessions.

“Now it is time for state leaders to roll up their sleeves and get to work closing Florida’s disgraceful coverage gap.”

Timothy Jost, a law professor at Washington and Lee University in Virginia, told Health News Florida that a ruling that eliminates subsidies would have affected Floridians within 60 days. 

“If the court rules that those tax credits are invalid, they would probably be shut off in a month or two. People who have already received tax credits this year, those would be fine. The ruling would not be retroactive,” he said in March, when the Supreme Court heard arguments in the case.

According to NPR and Kaiser Health News, Florida residents with subsidies average $294 in tax credits this year. A loss of that credit would increase the cost of their monthly premium by 359 percent.

The dispute before the Supreme Court centered on just four words within the Affordable Care Act. The health law mentions helping pay for premiums bought on state-run marketplaces, something just 13 states now do.

Jost said a Supreme Court decision in 2012 about Medicaid expansion and the Affordable Care Act looked broadly at the Affordable Care Act. That ruling led to many states, including Florida, to opt out of offering Medicaid expansion for its poorest, uninsured residents.

Jost predicted several months ago that the court would approach King v. Burwell in much the same way.

“I think that if they follow the law that they have laid down in other cases, they are not going to look at just four words, they are going to look at the entire statute,” he said. “And if they do that, they are going to see, that clearly what the statute says is that federally facilitated marketplaces can grant premium tax credits.”

The uncertainty of the court’s decision led Republican leaders in Congress to consider possible fixes if the subsidies were altogether eliminated. Last week, leaders in both the House and Senate were considering options that would temporarily continue subsidies for residents in the affected states.