With ACA subsidies secure, goal becomes achieving law's full potential

August 1, 2015

CHA president and chief executive officer

CHA and many others rejoiced when the U.S. Supreme Court ruled in favor of the Affordable Care Act and the American people. The court concluded that financial subsidies to help individuals and families afford health insurance are legal in every state, including the 34 states with federally run marketplaces. For millions of people in those states, the decision means keeping their health coverage instead of seeing it torn away from them.


Catholic health care worked so hard to persuade lawmakers and others that health reform was an urgent moral and economic priority. We advocated. We advanced principles. We never gave up, even when the political winds blew in the wrong direction. And, eventually we helped secure passage of the ACA, a solid foundation toward an affordable, effective health care system that serves everyone.

According to the United States Department of Health and Human Services and other sources, more than 16 million people have obtained health insurance because of the ACA. Many people would have lost their coverage if King v. Burwell had gone the wrong way: These include expectant mothers in the middle of a pregnancy, cancer patients in the middle of treatment, sick children with serious chronic diseases, financially struggling families losing their newfound health security — all hardworking Americans who love their families and who often hold jobs in which they wait on us.

Had the majority of Supreme Court justices sided with the plaintiff and removed insurance subsidies from federally run marketplaces, some 8.2 million people would have become uninsured, resulting in renewed confusion, anxiety and hardship for these working families. Meanwhile, a ruling for the plaintiff would also have increased non-group premiums in the 34 states by 35 percent, according to the Urban Institute, an economic and social policy research organization. In other words, it would have created chaos for patients, providers and the health care system overall. It would have been an unspeakably cruel outcome.

Thankfully, we have avoided that and hopefully we can continue working to improve the benefits of the ACA so that more Americans move into the new reality that having health care is not a privilege for some but an expectation of all. In this new reality, we can address quality and cost in ways that put the patient first and will result in a stronger, healthier and more prosperous nation.

As the people of Catholic health care, we can be proud of helping to create this new reality. Making health care possible for so many from the moment of conception until the moment of natural death is an incredibly pro-life accomplishment. We now have the responsibility to work diligently to realize all the potential of this legislation for each of our brothers and sisters. Millions live in states that will not allow the expansion of Medicaid enrollment even though it is already paid for. Millions also, because of all the negative publicity, simply do not believe there is the possibility for them to ever get health insurance and need our outreach to help them obtain the assistance that is rightfully theirs.

As President Obama said when he expressed gratitude to the Catholic health ministry at our assembly on June 9: "Thank you for your tireless efforts to make health reform a reality. Without your commitment to compassionate care, without your moral force, we would not have succeeded. We would not have succeeded had it not been for you and the foundation you laid."

We have helped to lay a great foundation. We must now be certain that those it was intended to help actually get what they deserve. This is the best way we can celebrate the victory in King v. Burwell, a great decision for the health of our nation and the security and dignity of those who live here.


Copyright © 2015 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2015 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.