On Tuesday, two federal appeals courts issued conflicting rulings on the legality of tax subsidies being provided to people who bought “Obamacare” health insurance policies in Oklahoma and 35 other states.
Here’s a look at the rulings’ potential impact in Oklahoma.
I’m confused. What did the courts rule today?
A three-judge panel of the U.S. Court of Appeals circuit in Washington, D.C., decided that the government can’t provide tax subsidies for Affordable Care Act plans purchased in 36 states where the federal government is operating the health insurance exchange. Oklahoma is one of the 36 states. A few hours later, the U.S. Court of Appeals circuit in Richmond, Va., issued a conflicting ruling that upheld the legality of the health-care law’s tax subsidies.
So what happens now?
The rulings have no immediate impact. The Obama administration said it would appeal the D.C. ruling to the full appeals court there. Even if that ruling stands, the legality of the tax subsidies ultimately might be determined by the U.S Supreme Court. These are only two of several Affordable Care Act lawsuits being litigated in various courts across the country.
How many Oklahomans are affected?
About 55,000 Oklahomans already are receiving tax subsidies for private health plans purchased through the federally operated exchange in this state. Thousands more might qualify if the subsidies are not struck down. They would not lose their policies if the D.C. ruling were to stand. But their monthly premiums would go up, in some cases dramatically.
Are they poor people?
Not exactly. Tuesday’s rulings don’t apply to anyone below the federal poverty line. They affect people with incomes between 100 percent and 400 percent of the federal poverty level. That includes single people with incomes between $11,490 and $45,960 a year, two people with incomes between $15,510 and $62,040, three people with incomes between $19,530 and $78,120, and four people with income between $23,440 and $94,200.
What do I do if I already bought a subsidized plan?
Sit tight for now. It could be months or even years before a definitive ruling is issued on the legality of the Obamacare subsidies. Federal and state officials said Tuesday all existing plans remain in effect, and subsidies will continue to be paid.
Are all Affordable Care Act exchange plans affected?
No. Only those issued in the 36 states with federally run exchanges, and only those qualifying for tax subsidies. In Oklahoma, 69,221 people had purchased Obamacare policies through April 19, according to the U.S. Department of Health and Human Services. Of those, 54,795 qualified for tax subsidies.
Did the state of Oklahoma participate in these lawsuits?
No. Attorney General Scott Pruitt filed a different lawsuit in 2011 challenging many of the Obamacare provisions covered by Tuesday’s rulings. His suit is pending before the U.S. District Court for the Eastern District of Oklahoma. A ruling in that case might be issued at any time.
Did this happen because Oklahoma rejected Obamacare?
Partly. The D.C. ruling would have no effect on insurance plans sold in the 14 states that opted to set up their own health insurance exchanges under the Affordable Care Act. A bill was introduced in Oklahoma to do that, but the Legislature decided against it in 2011.
Does this have anything to do with Gov. Mary Fallin’s decision to reject Medicaid expansion?
No. That was a separate decision involving a different part of the health-care law. In 2012, the governor announced that Oklahoma would not expand its Medicaid program by raising qualifying income levels or broadening the eligibility rules for poor adults.
Do Tuesday’s rulings affect SoonerCare participants?
No. SoonerCare is Oklahoma’s Medicaid program for adults below the poverty line and some children above it. The court rulings won’t affect any of them.
Do they affect Insure Oklahoma policyholders?
They won’t affect current participants. Insure Oklahoma is a limited program available to some low-income working adults and their dependents. The rulings could affect 7,325 people who were removed from Insure Oklahoma this year because it was assumed they would qualify for Affordable Care Act exchange tax subsidies.
Is Oklahoma preparing any kind of state-run program to help people affected by these rulings?
That’s not clear. The governor and other state officials have talked in the past about devising an “Oklahoma Plan” that would be an alternative to Obamacare. But Fallin’s office and other officials said Tuesday they weren’t sure whether anything would be done beyond this year’s revisions to the Insure Oklahoma program.
Are these government insurance policies?
No. In Oklahoma, exchange policies are being written by Aetna Life Insurance Co., Blue Cross Blue Shield of Oklahoma, CommunityCare, Coventry Health Care Inc. and GlobalHealth Inc. Blue Cross, the biggest provider with about 45,000 Obamacare policyholders, said Tuesday it was awaiting guidance from the federal government and had no plans to change anything for now.
Where can I get more information?
State officials said Tuesday they had no immediate guidance for people who purchased tax-subsidized policies on the Affordable Care Act exchange. For now, keep an eye on the news, or check the federal government’s official website: www.healthcare.gov.
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