The United States Supreme Court is set to vote on King v. Burwell, a lawsuit challenging the availability of tax subsidies for people who purchase health insurance under the Affordable Care Act.

If the challenge succeeds, millions of Americans who obtained health insurance through federal exchanges could lose their coverage.

Challengers argue that the ACA only allows subsidies to be received through state-run exchanges and that the regulation as implemented by the IRS, which provides for subsidies on both state-run and federal exchanges, exceeds authority granted by Congress.

“The language at issue is that only state-created exchanges are allowed to give subsidies,” said Lee Strang, professor of law at The University of Toledo. “However, only a few states set up exchanges.”

Congress does not have the power to force states to set up exchanges. In fact, 34 states have declined to do so.

“Massive, partisan, ‘you have to pass it to know what’s in it’ legislation is going to have errors,” Strang said. “These errors could have been avoided by deliberate, open, bipartisan reform efforts.”

According to Strang, if the challenge succeeds it could cause indirect harm to those who receive insurance through their employer because insurance companies would struggle to enroll enough customers to make their insurance plans feasible.

Rebecca Zietlow, Charles W. Fornoff professor of law and values at UT, echoed Strang’s concerns.

“This challenge is based on three or four words in a 1,000 page document,” Zietlow said. “The system is interconnected and companies are depending on people to buy insurance. If this passes, and people are no longer purchasing health insurance, it would completely destroy the market.”

The ACA has had a profound impact on decreasing the number of hospital patients without health insurance. So far in 2015, just 1 percent of patients at The University of Toledo Medical Center UTMC have been uninsured, down from 4.5 percent in 2013.

“The impact on us is real,” said Dr. Carl Sirio, chief operating and clinical officer for UTMC and senior associate dean for clinical affairs for the UT College of Medicine and Life Sciences. “The outcome will have a ripple effect across the country, primarily on those states without their own exchanges.”

Ohio is one of the 34 states using a federal exchange. If the challenge passes, more than 150,000 Ohio citizens will be without health insurance.

To schedule an interview, contact Aimee Portala at 419.530.4279 or aimee.portala@utoledo.edu.

Media Coverage
13 ABC, WTOL 11 and FOX Toledo (June 25, 2015)
WTOL 11 (June 25, 2015)
The Blade (June 26, 2015)
WTOL 11 (July 5, 2015)
Leading Edge with Jerry Anderson (July 5, 2015)

Tags: College of Law