via RAND Corporation

Later this month, the Supreme Court is expected to hand down its ruling in the case of King v. Burwell, a challenge to the Affordable Care Act (ACA) with potentially major consequences for millions of Americans who have received health insurance under the law’s coverage expansion provisions

The central question in this case is whether or not tax credits and cost-sharing subsidies can be provided to Americans in states that did not opt to set up their own state-based insurance marketplace (also known as exchanges). If the court rules in favor of the petitioners, Americans in the 34 states that have not set up marketplaces and are instead relying on marketplaces established and run by the federal government could lose their subsidies.

If tax credits and subsidies are deemed illegal in these states, health insurance could become unaffordable for many, and the likely exodus of young and healthy people from the market could lead to premium escalation. RAND research estimates that elimination of the tax credits in the 34 affected states could cause marketplace premiums in those states to rise by 47 percent, and 8 million fewer people to enroll in insurance..

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