In January, over half of all those that participated in the Kaiser Health Tracking Poll were unaware of a Supreme Court case, King v. Burwell , that could greatly impact many states’ economic growth and public health. What has made the Affordable Care Act successful is that individuals are able to receive financial help to purchase insurance plans and depending on the outcome of this case, many people may lose this assistance in states that rely on the federal marketplace instead of a state-run marketplace. The decision of the King v. Burwell case could potentially affect 1.6 million North Carolinians’ ability to access affordable health care. Approximately 560,000 North Carolinians have purchased insurance coverage using the federal marketplace and are at risk of losing subsidies that would then make health care too expensive. What is more, the King v. Burwell decision is linked to expanding Medicaid to nearly 500,000 people throughout NC as Governor McCrory has stated that he will wait until the Supreme Court decision before making a formal decision on Medicaid expansion. We also know that a dramatic shift in enrollment will have a major impact on private insurance companies that will likely drive rates up by 43 percent for everyone. Some insurers may pull out of the market altogether.
Leaders in many red and blue states are concerned about the potential impact of losing insurance subsidies, and they are creating response plans. Let’s hope this process is playing out behind-the-scenes in North Carolina as well. The same Kaiser poll reports that 82 percent of Democrats, 63 percent of Independents, and 40 percent of Republicans believe that the U.S. Congress should act to make sure that low-and-moderate income families continue receiving tax credits to purchase affordable insurance even if the Supreme Court strikes down subsidies. However, states do not have to rely on the federal government to pass a law to ensure access to affordable health care; some states are already preparing to develop state-run exchanges. Nationally, 51 percent of Republicans, 63 percent of Independents, and 61 percent of Democrats believe that states that rely on the federal marketplace should create their own state-run market places. North Carolina’s Governor and General Assembly should take the initiative and start constructing our own state exchange. If the Supreme Court decides not to uphold the subsidies for low-to-moderate-income individuals who rely on the federal marketplace, it’s not clear that NC has a plan. Across the U.S., 63 percent of people believe that Republicans do not have an alternative to the ACA. Our state can’t wait on Congress to come up with a solution. Waiting to act until a Supreme Court decision in mid-to-late June is risky and could leave many North Carolinians without health care and our insurance market in ruins.