On June 25, 2015 the U.S. Supreme Court upheld the federal government’s ability to provide subsidies to individuals in states that did not establish their own Exchange. Why does it matter?
- Individuals: The ACA created health insurance subsidies to help eligible individuals and families purchase coverage through an Exchange. These subsidies are designed to make Exchange coverage more affordable by reducing out-of-pocket healthcare costs. The Supreme Court’s decision allows individuals, enrolled in coverage through a federally run or state run exchange, to continue to receive these subsidies.
- Applicable Large Employers: Under the employer mandate, certain large employers may face penalties if they do not offer applicable coverage to their full-time employees. However, penalties apply only if an employee receives a subsidy through an Exchange. Since the subsidies will continue to be available to individuals, all applicable large employers will continue to be subject to penalties as the employer mandate dictates.
For more information, please visit the following link for the text of the Supreme Court Opinion: http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf