As you have no doubt heard by now, the Supreme Court issued a health care reform ruling this morning that confirms what we have known all along – that the law was designed to provide a tax credit to any American who qualifies, regardless of the type of insurance marketplace they use.  More broadly, the ruling reinforces the fact that the Affordable Care Act  (ACA) is the law of the land and is here to stay.

The 6-3 ruling is written in stronger terms than I dared to imagine. At the core of Justice Roberts’ 21-page opinion is this statement:

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Today’s ruling is based on the Court’s interpretation of the legislative intent, rather than being an example of the sort of decision that defers to a federal agency’s interpretation of the law. In other words, the Court ruled that there’s only one possible interpretation of the statute – that premium tax credits were intended to be available in every state. That’s very good news because deferring to the current IRS interpretation of the law would have meant that the next president could reverse the outcome by getting the IRS to amend the regulations about eligibility for premium tax credits.

The decision is great news for Wisconsin because our state relies heavily on the federal health insurance marketplace. The 166,000 people in our state who are receiving premium tax credits for insurance plans purchased through the federal marketplace now have peace of mind that the federal subsidies enabling them to afford health insurance will remain in place. And the ruling prevents a sharp increase in the cost of individual plans purchased outside the federal marketplace.

With this litigation out of the way, policymakers can now focus on improving health coverage for Wisconsin children and households, rather than squabbling about the law’s interpretation. Some of the next steps should be to improve outreach, fix the “family glitch” that excludes some family members from being eligible for premium tax credits, and improve access and quality under the ACA.

An especially important step in continuing to improve access to health care is to extend BadgerCare to additional low-income adults, which would significantly reduce the uninsured rate and the cost of uncompensated care incurred by hospitals. And by enabling Wisconsin to capture additional federal funding, expanding BadgerCare would yield a net savings for the 2015-17 state budget of $360 million.

You can read more about the importance of the marketplace subsidies in Wisconsin in a WCCF report issued last week, which also contains the estimated number of marketplace participants in each county.

Jon Peacock