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The Recent ACA Court Case

On Tuesday a divided panel of three judges from the U.S. Court of Appeals ruled that one of the major facets of the Affordable Care Act was illegal. In a vote of two-to-one, these judges said that the Federal Government could not provide federal financial assistance (also known as tax subsidies) to persons who enroll in health insurance using the Federally Facilitated Marketplace. South Carolina has a Federally Facilitated Marketplace, meaning the federal government maintains our enrollment process, as well as 35 other states. States had the option to participate in the Federally Facilitated Marketplace, create a State-Based Marketplace, or use some combination of both. We like a majority of states, chose to let the federal government facilitate our Marketplace to enroll in health insurance.

Reports have shown that as many as 90% of the individuals and families who enrolled in health insurance through the infamous website healthcare.gov received a tax subsidy. This would mean that those individuals and families who received money to help pay for their health insurance premiums would no longer be able to receive those funds. They made this decision off of a reading of the health care law, saying that they felt the law itself restricted the federal government from paying subsidies in states where it managed the Marketplaces.

A separate three panel judge ruled unanimously for the Obama administration, allowing subsidies to be available to residents in all states. This separate panel for a separate court believed that the health law is "ambiguous,” and therefore decided to uphold the IRS's interpretation of the law.

With two monumental decisions on the table, many critics and supporters of the law spent Tuesday discussing the possible outcomes of each ruling. It is important to note that nothing will change right now. If you received a tax subsidy to help pay for the cost of your health insurance, there is no need to stress right now. If you are looking to apply for insurance due to a special enrollment period, you will still be eligible for tax subsidies if your income meets the guidelines.

The President and his administration have announced that they will file an appeal, which will call all 11 judges of that first U.S. Court of Appeals to the table to look at the law and pass a ruling. Until there is a decision from the appeal, nothing will change. In fact, this could go as far as the Supreme Court. It could be weeks or months before there is any movement on either side of this law.

Lastly, these decisions only apply to policies sold through healthcare.gov. If you have insurance through your employer or other insurance such as Medicare or Medicaid, none of these court decisions will affect you.

If you have any questions or concerns, please feel free to contact Lee Patterson at 231- 6383 or via email.

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