A federal appeals court for the District of Columbia Circuit could potentially strike a huge blow to the Affordable Care Act.
The court will rule on Halbig vs. Burwell any day now, a case that could see potentially 100,000 Alabamians and 5 million people nationwide lose access to Affordable Care Act subsidies.
Section 1311 of the act states that only people who apply for health insurance plans through state-run health marketplaces are eligible for subsidies. However, only 17 states have created their own markets, with seven running marketplaces in partnership with the federal government, and 26 relying on federally run marketplaces.
Plaintiffs in the case argue that the subsidies are legal only for people who bought health insurance plans through state-run health exchanges, which could potentially leave everyone who applied through federally funded health insurance markets uninsured.
Mary Jones, a resident of Hobson City who is enrolled through the act, has been enrolled on the act since Jan. 1. Jones said she needs the insurance to be able to afford major treatments, many of which she needed years ago.
“I had major tests that I needed done when I was 50, and I’m 64,” Jones said. “It’s great for people to be the recipient of health care.
“I hope that the lawmakers will treat people justifiably,” Jones continued. “But I hope the Lord don’t allow this to happen. I don’t think it’s fair. It’s nothing for them to just make a law to hold other people back.”
The ruling could also have significant ramifications for the act’s individual mandate, which requires that all eligible Americans have health insurance.
Todd Boozer, the state president for the Alabama Health Underwriters Association, said he doesn’t believe the state or the country has the money to subsidize the health plans the way the act intends.
“We really don’t have money to subsidize the way we’re doing now,” Boozer said. “I know our country doesn’t have the money. I’m very uncomfortable with that.”
Gene Ramsay, vice president of media for the Birmingham Association of Health Underwriters, said the case could be bad for the act in Alabama, which had 98,870 people enroll for the act from Oct. 1, 2013 through March 31.
Still, Ramsay said he believes it will be a long time before any of the ramifications are felt if the courts rule against the act.
“Probably because it’s a federal case, and it could take years to get something figured out from this,” Ramsay said. “Also, this whole thing has got the president’s signature on it. So, I would probably have to veer toward the camp saying it wouldn’t have an immediate impact.”
Still, Ramsay said the case could open the door for future opponents of the act to continue to attack it. Ramsay said that many people who have followed the act suggest that if it is repealed, it will be from the inside-out.
“The prognostication is, it’s going to implode,” Ramsay said. “Now that the law is in effect, people are going to start digging into this hole, looking for loopholes, bringing them up.”
Jim Carnes, policy director at Arise Alabama, shares Ramsay’s sentiments on the potential ramifications of the court case. Arise Alabama is a statewide nonprofit organization to promote policies to benefit low-income Alabamians.
“It’s clear that Congress intended for subsidies to be available through marketplaces. Period,” Carnes said. “The plaintiffs are just exploiting a poorly worded passage to deny health care coverage to 100,000 Alabamians.”