ACA Court Decision Could Impact Exchange Subsidies for Some Employees

May 13, 2016

In a lawsuit filed by congressional Republicans, a federal district court judge decided this week that the Obama administration has been improperly funding certain Affordable Care Act exchange subsidies, a ruling which could impact low-income part-time employees who seek coverage on the exchanges.  If it stands, the ruling would effectively eliminate the ACA cost-sharing exchange subsidies, which help people pay for out-of-pocket costs like co-pays at a doctor's office.  Although it would not impact the premium subsidies, it would push insurance costs higher in the ACA exchanges, further disrupt the risk pools, and likely cause some carriers to reconsider their participation in the exchanges.  The cost-sharing exchange subsidies are currently available for individuals with incomes between $11,880 and $29,700, and for families of four with incomes between $24,300 and $60,750.  The judge has stayed her ruling pending an appeal by the Obama administration.