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Supreme Court Allows Nationwide Health Care Subsidies

by Vita, on June 25, 2015


This morning, the Supreme Court upheld a key provision of the Affordable Care Act and agreed with the Obama administration that government premium subsidies for low-income Americans should be available to all who qualify, regardless of whether the coverage is purchased on a state-sponsored exchange or other type of exchange.  They were specifically addressing the roughly six million Americans enrolled in the Federally sponsored exchanges who qualify for a subsidy.

By a 6-3 vote, the divided court affirmed the Internal Revenue Service ruling that subsidies should be available not only in states that have set up their own health insurance exchanges, but also in those where consumers rely on the federal government exchange.  Since California has its own state-run health insurance exchange, Covered California, repeal of the subsidy would not have had any impact to those enrolled with a subsidy here in our state, but would have had a very significant impact in many states.

While we may agree or disagree with this action, the good news is that we have what we need more than anything today: closure and direction

Serving our valued clients is our top priority.  While the insurance industry still awaits some key ACA regulation and clarification of existing guidance, Vita is focused on helping our clients make progress with the next phases of ACA implementation.  In the coming weeks and months, we will be connecting with affected clients to review:

  • Market transition and options for employers with 51-99 employees (as the definition of small employer moves to 100+ in 2016)

  • PCOR and Transitional Reinsurance Fee payments for self-funded health plans (due July 1 and Jan 1, respectively)

  • Payroll 1094/1095 reporting tools and timelines (reporting on 2015, in Jan 2016)

  • The Cadillac Tax and how to create a benefits strategy around it