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Update on the Affordable Care Act. King v. Burwell and Obergefell v. Hodge
Sarah M Lyon1,2, Nuala Moore3, Ivor S Douglas4
11 Division of Pulmonary, Allergy and Critical Care, Hospital of the University of Pennsylvania, and.
Insights
The Affordable Care Act expanded health insurance access for millions. A key Supreme Court ruling in King v. Burwell upheld subsidies, protecting coverage for those using federal marketplaces.
Area of Science:
- Health Policy
- Public Health
- Healthcare Law
Background:
- Lack of health insurance creates disparities in care and outcomes for patients with respiratory diseases, critical illness, or sleep disorders.
- The Affordable Care Act (ACA) aimed to reduce these disparities by expanding health insurance coverage.
- The ACA established insurance premium subsidies for low- and moderate-income individuals purchasing policies on health insurance marketplaces.
Purpose of the Study:
- To analyze the impact of the Affordable Care Act on health insurance access.
- To examine the legal challenges to the ACA, specifically the King v. Burwell case.
- To assess the implications of Supreme Court rulings on healthcare access and benefits.
Main Methods:
- Review of the Affordable Care Act legislation and its provisions for insurance premium subsidies.
- Analysis of the legal arguments and Supreme Court's decision in King v. Burwell.
- Examination of the Supreme Court's ruling in Obergefell v. Hodge and its impact on benefits.
Main Results:
- The Affordable Care Act has enabled approximately 16.5 million Americans to gain health insurance.
- The Supreme Court's ruling in King v. Burwell affirmed the legality of insurance premium subsidies for individuals using the federal HealthCare.gov marketplace, protecting coverage for millions.
- The Obergefell v. Hodge decision legalized same-sex marriage, granting access to state and federal benefits and protections for same-sex couples.
Conclusions:
- The Affordable Care Act and subsequent Supreme Court decisions have significantly improved access to health insurance and associated benefits for vulnerable populations.
- Legal challenges have affirmed the ACA's provisions, ensuring continued coverage and access to care.
- The rulings have had a profound impact on public health by reducing disparities and expanding rights.
Abstract:
Patients with respiratory diseases, critical illness, or sleep disorders who lack health insurance endure disparities in access to care and worse health outcomes. These disparities were partly addressed in the United States in 2010 by passage of the Affordable Care Act. Low- and moderate-income individuals and families with incomes between 138 and 400% of the federal poverty level are eligible for insurance premium subsidies when purchasing policies on the health insurance marketplace exchanges. Since the act was passed, nearly 16.5 million Americans have gained health insurance. In 2015, the act survived what may be the last significant judicial challenge to the law: King v. Burwell. The plaintiffs challenged whether people who purchased health insurance in states that use the federal insurance marketplace HealthCare.gov , rather than a state-run marketplace, were eligible to receive insurance premium subsidies. At the time of the ruling, 34 states used the federal exchange, and as a result, nearly 7.5 million people could have lost their health insurance if the court had ruled in favor of the plaintiffs. However, in King v. Burwell, the Court ruled six to three in support of the legality of subsidies regardless of type of marketplace states use, thereby ensuring continued health insurance coverage for patients in states using the federal marketplace exchange. In 2015, the Supreme Court also heard a landmark case, Obergefell v. Hodge, in which the Court upheld the right for two people of the same sex to marry, thereby opening crucial access to both state and federal benefits and protections for same-sex couples.
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