A new report from the Obama administration highlights the very high stakes for a challenge to the Affordable Care Act before the Supreme Court. The subsidies that the court may eradicate are helping a large majority of HealthCare.gov customers pay for their health insurance.
The report is the first time that the Department of Health and Human Services has delivered some numbers on exactly who is signing up for health insurance for 2015, since the open enrollment period began in mid-November.
The data that was used isn’t perfect or complete — and many commentators rightlygrumbled about its shortcomings — but the report is still a helpful snapshot of whom the new insurance markets are serving. It’s particularly detailed in looking at the people using the marketplaces in the 37 states that are letting the federal government manage their enrollment.
Over all, it found, customers who were using HealthCare.gov to pick insurance plans — some new customers, and some renewing customers — were overwhelmingly likely to qualify for federal subsidies to help them pay their premiums. On average, the report found that 87 percent of these customers were eligible for subsidies, with higher percentages in some states — up to a high of 95 percent in Mississippi.
Those numbers don’t include everyone in the marketplace; people who were enrolled in plans this year and simply automatically renewed them weren’t counted. But it’s reasonable to think that the proportion is representative. Last year’s number at the end of open enrollment was an average of 85 percent. A different report, also published Tuesday, said that a total of 6.5 million people in those states had selected plans or been automatically renewed into plans as of last week.
The plaintiffs in the Supreme Court case, called King v. Burwell, argue that the law does not allow the subsidies to help insurance customers in the states letting the federal government run individual insurance marketplaces. And if the court agrees, all those people would lose their subsidies, and many would be priced out of the market.
We’ve written before about the disruptionssuch a rulingwould cause. But as more people sign up for health insurance — and more of them are relying on federal subsidies — the potential impact of the decision grows.
So far, outside of official briefs, administration officials have been quiet about any concerns about the case. Asked several times last week in a news conference about possible contingency planning, the H.H.S. secretary, Sylvia Mathews Burwell, insisted that her department was confident that the government would win in court and that it was focusing its efforts on signing up new insurance customers. But a department news release Tuesday highlighted the high rate of subsidy, suggesting that federal officials were aware of the case’s possible reach.