Today, the United States Supreme Court upheld subsidies for individuals who purchase health care insurance through all health care exchanges regardless of whether the exchange was established by a state or the federal government. The case, King v. Burwell, is the latest ruling in a number of challenges to the Affordable Care Act (ACA). In the 6-3 ruling, the Court stated that this ruling will prevent the destabilization of the individual health insurance market into a death spiral.
What does this mean to the average American? If you purchase health insurance from an exchange and meet the eligibility requirements, then you may continue to receive subsidies to help pay for that coverage. It does not matter that you are in a state exchange or a federal exchange. So, essentially status quo.
What does this mean to the average employer? The subsidies available through the exchanges are the triggers for the penalties that may be imposed upon certain large employers if that employer either fails to offer coverage to its full time employees or offers coverage that is not affordable or does not provide minimum value. Had the subsidies been taken away, then employers in states with federal exchanges would likely have not been subject to the penalties because in order to be subject to a penalty, an employee would have to purchase insurance on an exchange AND receive a subsidy. Subsidies are not available to employees if they have an appropriate offer of coverage from an employer. So, if you are a large employer and were hoping that you would not be subject to the penalties under the ACA, you should review your policies and procedures to ensure compliance with the ACA.