Last month's ruling from the U.S. Supreme Court on the Affordable Care Act means more than 1.4 million Floridians will keep their tax subsidies for health plans purchased on the federal marketplace at HealthCare.gov.
Florida and three dozen other states opted to use the federal marketplace instead of creating their own. That prompted a case that challenged the availability of tax subsidies for people in states that did not create their own marketplaces.
For a look at the ruling that keeps the subsidies in tact, we turned to USF Health's Jay Wolfson, professor of public health and senior associate dean for health policy and practice at the Morsani College of Medicine, who has followed the technical and policy issues in the case.
LOTTIE WATTS: This ruling from the Supreme Court is a big deal for Florida, which did very well with enrollment. It actually led in enrollment in 2014, and about 90 percent of people in Florida who signed up got tax credits to cover part of the monthly premium. What would have been the effect if the Court had ruled against tax subsidies and gone the other way on this?
JAY WOLFSON: Well, it would have been a mess. Sometime within the next few months, unless the Florida Legislature created a state-run exchange and became eligible for the tax subsidies, which given the political posturing and composition of our legislature, was not likely, those policies would have essentially lapsed because people would not be able to pay for them.
And you had many people who have had two and three years’ worth of experience gaining access to care for the first time for preventive services for health promotion, for wellness, for mental health services that they never had before. They would find themselves not being able to get continuous care, or they’d have to find a way to find the money to get it.
So we’d find ourselves kind of back where we year four or five years ago, except it’s worse, because now you’ve gotten people experienced to using it, having access to care that they previously didn’t have, and you’re kind of taking it away from them, or making it more difficult for them to access it. And that creates a different kind of spiral of bad things.