Speculation Abounds after Supreme Court Hears Oral Testimony on King v. Burwell

On Wednesday March 4, the Supreme Court heard oral testimony on King v. Burwell, the case that could terminate subsidies to residents of the 34 states with federally run health insurance marketplaces. Speculation focuses on Justices Kennedy and Roberts, whom most SCOTUS-watchers deem likely to cast swing votes. Justice Kennedy in particular raised constitutional concerns about the plaintiffs’ argument, but also gave a nod to their plain language read of the statute. Justice Roberts was uncharacteristically quiet, leaving wide berth for speculation. The Solicitor General, representing the federal government, faced questioning regarding his argument that the statute is ambiguous, thus allowing the Internal Revenue Service to interpret it and determine if subsidies may be provided through HealthCare.gov. The Court's ruling is expected at the end of June.

Democratic Senators Ask HHS for Special Enrollment Period for Pregnant Women

The Senate Health, Education, Labor, and Pensions Committee Ranking member Senator Patty Murray (D-Wash.)—along with 36 other Senators—sent a letter to HHS Secretary Burwell requesting that pregnant women be permitted to enroll in coverage through Marketplaces outside of annual open enrollment periods. Currently, in Federal and State-based Marketplaces, while the birth of a child provides mother and baby with a special enrollment period, a woman becoming pregnant does not. State-based Marketplaces have flexibility to define and establish special enrollment periods (SEPs), though none has done so for pregnancy to date. The Senators cited concerns that a woman who is ineligible for Medicaid and either uninsured or enrolled in a grandfathered plan that does not cover maternity services will be unable to obtain adequate pre-natal care. CMS declined to establish a pregnancy SEP in regulations released on February 27, 2015, but reiterated the HHS Secretary’s flexibility to do so. In response to the Senators’ letter, Secretary Burwell stated that HHS is open to considering the issue.

Affordable Care Act Will Cost Taxpayers Less While Coverage Estimates Decrease

According to data released by the Congressional Budget Office, the Affordable Care Act’s provisions will cost a total of $1.2 trillion over the next decade, $142 billion less than the agency had predicted in January 2015. This decrease in estimated cost is a result of two factors: (1) the lower-than-expected cost of health insurance premiums, thus decreasing the cost of subsidizing that coverage; and (2) the fewer-than-expected number of uninsured people prior to the ACA, meaning fewer people will gain coverage as a result of the law. The CBO estimates the number of people who will gain coverage will be 25 million by 2025, down from previous estimates of 27 million. The CBO has also decreased the number of consumers who will enroll in Marketplace plans by 1 million to reflect current enrollment trends.