Daily Journal Jackson Bureau
JACKSON – Insurance premiums could skyrocket as much as 95 percent for about 60,000 Mississippians if a court ruling striking down a key provision in the Patient Protection and Affordable Care Act stands.
“It would be devastating for Mississippi working families,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program of a ruling released Tuesday by a three-judge panel of the U.S. Court of Appeals for the District of Columbia.
By a 2-1 margin, the Washington, D.C., court found that the Affordable Care Act was written in such a manner that people who sign up for insurance through the Affordable Care Act, better known as Obamacare, could not receive federal subsidies to help pay for their insurance if their state did not create its own health insurance exchange.
The law’s supporters contend the reference to state exchanges was a language glitch and that it was the clear intent of Congress to allow subsidies for insurance obtained on either state or federally run exchanges.
The Obama administration will seek a hearing before the full 11-member D.C. Court of Appeals, which observers said because of its makeup would likely be inclined to overturn the ruling that could make insurance unaffordable for as many as 5 million people nationally, including the more than 60,000 in Mississippi. In the meantime, the subsidies remain in effect.
Indeed, also on Tuesday, another federal circuit court – this one based in Virginia – issued a contradictory ruling, saying people in states that rely on the federal exchange instead of a state exchange are eligible for the subsidies.
Only 15 states established their own health insurance exchange under the Affordable Care Act. People in those states would not lose their federal subsidies to help purchase health insurance even if the ruling of the D.C. court stands.
In many Republican-led states, the political leadership opted not to create their own exchange because they did not want to participate in helping enact the ACA. Other states opted not to start their own exchange because they saw no need to duplicate what the federal government already was doing.
In Mississippi, Republican Insurance Commissioner Mike Chaney supported establishing an exchange because he reasoned he could mold it to fit state needs better than federal officials. But Republican Gov. Phil Bryant blocked the establishment of the exchange, saying he did not want to do anything to help the ACA succeed.
Despite opposition from Bryant and much of the rest of the state’s Republican leadership, about 63,000 Mississippians still have obtained health insurance through the exchange, according to various sources. Mitchell, of the state Health Advocacy Program, said about 90 percent of those people received federal subsides because of their income level. He said many received “substantial subsidies.”
Chaney pointed out Tuesday that the enforcement of the ruling of the D.C. court was delayed by the judges for 45 days and that he believes it would be appealed before then. Still, he said the ruling creates “uncertainty.”
Asked if he would try again to create a state-based exchange to dispel that uncertainty, he said, “not with statewide elected officials being in conflict” on the issue.
Bryant indicated Tuesday he still opposes a statewide exchange even if it means 60,000 Mississippians could face higher premiums.
Nicole Webb, a spokeswoman for the governor, said, “Today is just another example of how deeply flawed this law is, and he remains opposed to signing Mississippi taxpayers on to what many have rightfully described as a train wreck.”
A study by Avalere Health, an independent health care consulting firm, estimated premiums would increase 76 percent nationwide for people who receive their insurance on the federal exchange if the D.C. court ruling stands. In Mississippi, Avalere concluded the premiums would increase between 80 and 95 percent, making it difficult for many people who work at jobs where their employers provide no health insurance to retain their health care coverage.
Other studies already have pointed out Mississippi is the only state where the percentage of uninsured people is increasing. Mississippi leaders opted not to participate in another provision in the ACA, expanding Medicaid for the working poor. As many as 300,000 Mississippians could have obtained coverage through that provision.
According to WalletHub, a social media company that allows people to shop for “smarter financial decisions” and does a litany of state rankings on various issues, Mississippi now has the nation’s second highest level of uninsured people at 21.6 percent of its population.
Of the D.C. court ruling, Bryant said, “As I have long said, I believe the IRS violated the law when it authorized massive taxpayer funded subsidies in the 36 states that declined to establish Obamacare exchanges, thereby triggering unwarranted taxes and mandates on both individuals and employers. Today’s ruling is another step in dismantling Obamacare and returning the control of individual health care to the people.”
Asked about the possibility of Mississippians losing insurance they got through the Obamacare exchanges, Lt. Gov. Tate Reeves said, “The question of what happens to Mississippians and thousands across the country affected by today’s ruling lies at the feet of President Obama and Democratic Congressional leadership. The flaws in Obamacare are endless.”
Mitchell said of the reaction of state leaders to the ruling and the prospect of people losing health care, “We continue to be at the bottom in so many health care indicators because our elected leaders work hard at it.”