What Will the King v. Burwell Decision Mean for Health Care Providers?

An upcoming U.S. Supreme Court decision could have a major impact on the health care industry. In King v. Burwell, the plaintiffs believe the text of the Affordable Care Act (ACA) only allows for subsidies to be provided to policyholders in state-run exchanges. Additionally, they believe the regulations implemented by the Internal Revenue Service, which allow for subsidies on both state-run and federal exchanges, exceed the authority Congress has given the agency.

If the challengers are successful in the lawsuit, approximately 5 million Americans with insurance coverage through federal exchanges could potentially lose their subsidies and, eventually, their insurance. However, the decision doesn’t just affect individuals — it could seriously impact health care providers, as well.

A potential dilemma for providers

If the plaintiffs are successful, hospital executives would be forced to figure out how they will treat people if they lose their coverage, but still attempt to seek health care services from the organization. Because thousands of people who received insurance thanks to these subsidies had never had insurance before, it could create a significant dilemma for providers if the patients were to suddenly lose their policies.

States would have three different options to ensure residents continue to receive coverage if the plaintiffs are successful. They could quickly create a state exchange, rent coverage from the government or join together with other states to share an exchange. Any of these options would require a lot of reorganization and adaptation at health care facilities around the country — at a time when the industry is already in a state of flux.

Health care professionals are watching this case with great interest. For more information on how the Supreme Court’s decision could affect your health care organization, and to prepare accordingly, meet with an experienced New York attorney at Buttaci Leardi & Werner, LLC.

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Posted in: Regulation