If the Supreme Court rules in favor of the plaintiffs in King v. Burwell, nowhere will the effect be more stark than along the 400-mile border between two states my family has called home, Tennessee and Kentucky.
In the state where I grew up, Tennessee, thousands of people would in all likelihood be forced back into the ranks of the uninsured. That’s because the cost of coverage would quickly skyrocket for the 230,000 Tennesseans enrolled in a health plan this year through the insurance exchange that’s operating there.
In Kentucky, where we lived when I worked for Humana Inc., it doesn’t matter what the Supreme Court does. No one there is facing the threat of suddenly finding their coverage unaffordable.
Kentucky is one of the 16 states (and the District of Columbia) that decided to establish and operate its own exchange. Tennessee, on the other hand, is one of the 34 states that defaulted to the federal government to operate its exchange.
The plaintiffs in King v. Burwell argued before the high court last Wednesday that because of the way the Affordable Care Act is worded, the Obama Administration is breaking the law by providing subsidies to people in those 34 states to help them buy health insurance. Their argument is that the law allows subsidies only for enrollees in an exchange “established by the state.” If the Court agrees, the subsidies for folks in exchanges operated by the federal government could come to an abrupt end as early as mid-summer.