The Affordable Care Act: what's next?

• Position: STATESTATS

The Affordable Care Act's roller-coaster ride continues. In the second case to reach the U.S. Supreme Court on federal health care reform--King v. Burwell--the justices will soon decide whether the subsidies offered to middle- and low-income purchasers of insurance through federally run health exchanges are legal. The decision would have no effect on people in the 16 states (plus D.C.) who purchase insurance through state-run exchanges. About 7.5 million people in the 34 states that use the federal exchange (or a state-federal partnership) could lose their subsidies if the court rules in favor of the plaintiffs.

Health Insurance Exchange Structures

ACA Timeline

2010

ACA becomes law First state-run exchange created

2011

States debate whether or not to create exchanges

2012

Supreme Court upholds ACA individual mandate and makes Medicaid expansion optional

2013

Exchanges open to public

2014

Coverage begins

2015

Supreme Court to rule on subsidies

Who Could Be Affected? (The number of people, and their share of the population, who are under age 65 and now receive subsidies in the 34 states with federally run exchanges or state-federal partnerships.) NUMBER OF PERCENT OF INDIVIDUALS POPULATION Alabama 152,760 3.7% Alaska 19,134 2.9% Arizona 156,306 2.8% Arkansas 57,802...