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Kaiser Releases New Analysis Detailing Potential Impact of King V. Burwell

June 30, 2015

The Kaiser Family Foundation announced a new analysis and interactive maps showing the potential impact of a ruling in favor of the plaintiffs in King v. Burwell, the case currently before the U.S. Supreme Court challenging whether low- and moderate-income citizens are eligible for federal subsidies to help pay for insurance in states where the federal government established new insurance marketplaces under the Affordable Care Act (ACA). The analysis uses 2015 data released this month to explore outcomes for residents of 34 states by determining the total number of residents in each state who would lose premium assistance, total dollars in subsidies lost in each state, average size of lost subsidy, and average percentage increase in premium.

If the Supreme Court rules in favor of the plaintiffs in King v. Burwell, their ruling could adversely affect access to healthcare for workers with disabilities whose earnings are higher than the Medicaid cutoff and do not have access to either a Medicaid buy-in program or employer-sponsored health insurance. States where the income cutoff for Medicaid Buy-in programs is lower than 400 percent of the Federal Poverty Level (FPL) include Alaska, Arizona, Indiana, Kansas, Louisiana, Maine, and North Dakota. In addition, states like North Carolina have an asset limit for the Medicaid Buy-in program. Many of these limits include the income or assets of spouses as well. Workers with disabilities above these income cutoffs (or above the asset limit) would not have access to a Medicaid Buy-in program, and therefore may have to depend on subsidies through the Exchanges. Other people with disabilities may be unable to access managed care long-term supports and services (LTSS) if they are ineligible for Medicaid coverage and unable to access financial assistance to cover the high costs of LTSS. Medicaid is the largest payer for LTSS, as private insurance premiums for the same services are unaffordable for lowand middle-income individuals and families.