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King v. Burwell decision could mean no Obamacare subsidy: 5 tips to prepare for the possibility

King v. Burwell decision could mean no Obamacare subsidy: 5 tips to prepare for the possibility

What is at stake with King v. Burwell, the case that the Supreme Court is debating?

It boils down to this: If your state does not have its own health insurance marketplace, can it offer subsidies, on your Obamacare coverage…subsidies that make high-deductible health insurance premiums affordable for so many? 

Currently, subsidies are offered in all states, but the King v. Burwell plaintiffs object to statutory wording and argue that credits are available only for those who buy insurance on state healthcare exchanges rather than on a federal marketplace. A ruling on the case is expected in June. 

A decision in favor of King could end subsidies for millions of insureds. It is important, however, to remember that if you live in one of the 16 states that has its own health insurance marketplace, tax credits are available. “If your state has its own exchange, you don’t have to worry about it,” says Harold Pollack, Ph.D., Helen Ross Professor at the School of Social Service Administration at the University of Chicago, where he is also an executive committee member of the Center for Health Administration Studies (CHAS). For a list of states that have their own exchanges, click here.

Although Pollack is optimistic that subsidies will stay in place (“Taking health insurance away from millions of people based on such a case is unlikely,” he says), he acknowledges that no one knows exactly how the Supreme Court will rule. 

The 5 tips below may help you prepare if subsidies are no longer part of Obamacare. 

  1. The Obama administration has created a special open enrollment period that runs through April 30, 2015. If you have not yet enrolled in an Obamacare major medical plan, get a quote
  2. Schedule elective surgeries and other procedures now while you have major medical coverage. 
  3. Make sure you get your physical. When you use in-network providers, preventive care is covered 100% under Obamacare. Such care could unearth health issues you can take of while you have coverage.
  4. Take advantage of prescription drug coverage that offers ordering in bulk. Pre-order prescribed medication so that you have it on hand. 
  5. Get a quote on short term medical coverage1, and check out supplemental products like Metal Gap2 with your agent. This way, you can budget accordingly and be ready for changes in your health insurance coverage. 

Which coverage is right for you? 

Get a major medical quote 

Get a short term medical quote 

Review Metal Gap plans 


1SHORT-TERM MEDICAL EXPENSE (STM) 

THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

2THIS PLAN IS NOT CONSIDERED TO BE MINIMAL ESSENTIAL COVERAGE AS DEFINED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA). ENROLLING IN AND MAINTAINING THIS PLAN WILL NOT EXEMPT YOU FROM THE SHARED RESPONSIBILITY PAYMENT (TAX) THAT MAY APPLY IF YOU DO NOT HAVE PLAN WITH ACA-COMPLIANT COVERAGE.

About IHC Specialty Benefits, Inc. 

IHC Specialty Benefits, doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products through general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit http://www.HealtheDeals.com