The health coverage of millions of Americans in 34 states was pending upon the Supreme Court decision on the King v Burwell case. Luckily, common sense prevailed and the Supreme Court based its ruling on the original motivation behind the creation of the exchanges rather than on the plain language used in the provision.
King v. Burwell was one of the lawsuits that challenged the tax subsidies received by individuals purchasing health coverage through federally-run exchanges in the 34 states that have not implemented their own exchanges. Because the Internal Revenue Code section 36B explicitly states that subsidies would be provided for “qualified health plans offered in the individual market (…) and which were enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act or (...),” the plaintiffs argued that those who purchase insurance through federally-run exchanges would not qualify for the tax subsidies. Coordinated by the Competitive Enterprise Institute, this lawsuit was originally filed on behalf of Virginia residents. Although in July 2014 the US Court of Appeals for the Fourth Circuit ruled unanimously for the government, the US Supreme Court announced in November 2014 that it would hear the case. With a 6-3 majority, the Supreme Court ruled in favor of the administration last Thursday. Claiming that “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them” and that “subsidies are necessary for the federal exchanges to function like their state exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid,” the Supreme Court gave its much-deserved consideration to the rationale behind the creation of exchanges rather than to the mere language used in the provision.
As a result of this ruling, individuals and families purchasing qualified health plans through the federally-run exchange will continue to receive their premium subsidies and cost-sharing reductions. This Supreme Court decision is good news because for millions of Americans, a ruling in favor of the plaintiffs would have had the following consequences:
The Supreme Court ruling, therefore, is nothing but good news for those 4.6 to 9 million Americans in 34 states that will continue to receive subsidies to purchase health insurance plans through the federally-facilitated exchange. Even if I still can´t come to terms with such a weak argument making it to the Supreme Court (in a country with over 300 million people, I expected the Supreme Court to have more important things to do than hear such a puerile argument), it is good to know that common sense finally prevailed.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Study Links COVID-19 Pandemic to Rise in Neoadjuvant Chemotherapy for Ovarian Cancer in US
April 17th 2024There was greater use of neoadjuvant chemotherapy among US patients with ovarian cancer (OC) during the COVID-19 pandemic to reduce potential COVID-19 exposure and cancer treatment-related complications.
Read More
Need for Pharmacogenomic Testing in Mental Health Care Explored at AMCP 2024
April 17th 2024Presenters from Mayo Clinic discussed the benefits of implementing pharmacogenomic testing in mental health care for the betterment of patient outcomes, reducing medical costs, and more at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting.
Read More