Later this month, the Supreme Court is set to hand down a decision on t
he second major challenge to the Affordable Care Act, commonly referred to as Obamacare.
King v. Burwell revolves around whether the Obama administration is entitled to provide healthcare subsidies to millions of Americans living in the 36 states that didn’t set up healthcare exchanges on their own.
Several conservative activists brought the case after they discovered that four words in the law appear to suggest that healthcare subsidies wouldn’t be allowed in states that didn’t set up their own exchanges. The law itself says that subsidies can be provided through exchanges “established by the state.”
If the court sides with the plaintiffs, millions of Americans in states that did not set up their own exchanges will essentially forfeit or be forced off of their plans because the federal government won’t be able to subsidise their insurance anymore.
To illustrate which states would be hit hardest, we’ve collected maps that show the impact that Obamacare has had on the insurance landscape.
More Americans have insurance now than before Obamacare
This Metric Map shows the percentage of uninsured Americans in each state in 2010, before the Affordable Care Act passed. The red shows high percentages, while green signifies the lowest. As you can see, the percentage of uninsured people was relatively high in the Southern states.
Before the law’s passage, the number of uninsured rose to record highs. In 2006, the percentage of uninsured hit an all-time high of 16%
with close to 44 million Americans lacking insurance.
The ACA has vastly increased the number of Americans who have health insurance. By the end of this year’s open enrollment period, 11.7 million Americans signed up for insurance under Obamacare, according to figures released by the Obama administration. As CNN notes, fewer than 12% of Americans are now uninsured.
As you can see from this map, there are only a handful of “red” states with high percentages of uninsured people in a post-Obamacare world. The below map could look a lot different if the Supreme Court rules for the Obamacare challengers.
This county-specific map by Enroll America shows the number of counties with high percentages of uninsured.
Here’s what the map looked like in 2013. The dark blue areas had an uninsurance rate higher than 10%.
The next year, the shift was huge. See the county-specific info here.
An anti-Obama ruling would likely hit the South hardest
One of the great ironies that Obamacare advocates point out is that many of the states that stand to benefit from Obama’s healthcare law also oppose it.
As The Washington Post points out, virtually no states in the South accepted money from the federal government to set up their own state exchanges.
Maps from the Washington Center for Equitable Growth show that many of the counties that stand to benefit the most from subsidies lie in poor southern states like Mississippi, which declined to set up a state exchange.
This is what makes the stakes so high for the case. Many of the counties with the highest percentage of residents eligible for subsidies are also in states that have refused to set up their own healthcare exchanges.
As data mapped by the Kaiser Family Foundation show, states including Texas, Florida, and Mississippi have some of the highest numbers of subsidy recipients who would see huge increases in premium cost if the subsidies disappeared.
This would likely force thousands of healthy younger subsidy recipients to drop out, which would eventually raise premium rates for older recipients. Scroll down to view the interactive map.
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