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Helping the Supreme Court decide King v. Burwell

February 16, 2015
by Ron Manderscheid
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Recently, the U.S. Supreme Court elected to hear the King v. Burwell case in order to decide a question being raised about the Affordable Care Act (ACA). The question is whether or not the U.S. Department of Health and Human Services (HHS) can make federal insurance premium subsidy payments under the ACA if the insurance was purchased through the federal health insurance marketplace rather than through a health insurance marketplace operated directly by a state. The consequences of this decision will be very far-reaching, since 37 of the state health insurance marketplaces currently are operated by HHS.

Clearly, we very strongly support the principle that HHS does indeed have the authority under the ACA to pay these premium subsidies. To decide the contrary would be to throw the entire ACA insurance system into national chaos. Up to this point, more than 80% of persons who have enrolled in marketplace health insurance are receiving a tax subsidy, and the majority of these persons would be adversely affected by such a decision.

However, the issue is not just a legal one; it also is a human concern. Below, we present three actual first-person accounts that show how both the health insurance and the premium subsidy have had far-reaching positive personal consequences. (A very special thanks to Sita Deal at NAMI and Theresa, Allie, and Kevin, who not only have agreed to tell their personal stories, but also have agreed to be identified.)    

Theresa’s Story

 “I applied for insurance online through the marketplace.  During the online application I became confused and called it: the customer service rep. walked me through the rest of steps.  She was great. Since having insurance I was able to be hospitalized and receive the intense mental health treatment that I needed without the burden of a huge hospital bill.  I am now able to see my psychiatrist, dietician,  and a therapist at an affordable price.  I am also on the medications that I need to be on: ones that are effective for a total of $20 a month instead of over $300.  The marketplace impacted my life in the way it gave me my life back.  I have been able to receive the mental health care I need to be proactive in recovery and lessened the financial burden on myself.  I've been able to seek help and afford to live independently.”

Threasa J Kluever
Aurora, Illinois

Allie’s Story

I just came from under my parent's insurance because I turned 26. Their insurance literally saved my life due to hospital stays and therapy treatment for severe depression. I still suffer from depression, though not as severe, and knowing that the affordable care act gives me visits to therapists at little cost to me gives me one less thing to stress about as a student. It's really amazing how much this has helped me.”

Allie Groves
Cheney, Washington

Kevin’s Story



Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid


Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

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