Local Obamacare consumers granted reprieve

June 25--Karen Campbell breathed a sigh of relief Thursday after the Supreme Court ruled to maintain financial aid for her and tens of thousands other Ohioans who rely on federal tax credits to help pay for health plans under the Affordable Care Act.

"Having health insurance has been a Godsend for me, and I did not want not to have insurance," said the 63-year-old Centerville resident. "What if I have a heart attack? What if I come down with cancer? That's what's frightening about not having insurance."

Campbell signed up for subsidized coverage last year through Ohio's health insurance marketplace after she was laid off from her job at the public library in Waynesville, Ohio. Her subsidy, offered only through the marketplace, lowered her monthly premium for a comprehensive gold-level plan to $322 from $850 without a subsidy.

But the question before the high court was whether her subsidy should be withdrawn because it not provided through a marketplace, or insurance exchange "established by the state," as the law was written.

A decision against the subsidies in 37 states could have potentially displaced more than 6 million Americans who rely on them, including more than 161,000 Ohioans, according to figures from the U.S. Department of Health and Human Services.

For Campbell, a ruling in favor of the plaintiffs would have effectively raised her monthly insurance premium by more than $500.

"I couldn't afford that," said Campbell, who lives on a limited income from a retirement account. "I would have been forced to try to find cheaper insurance on my own or go back to paying out of pocket. Before I signed up for insurance (through the marketplace), I was basically paying out of pocket for my medical care, which was extremely expensive. I'm a diabetic, and I've had some other health issues that mean I have to see a doctor.

"I never understood the opposition to the health care law," she said. "This program is working and providing health insurance for millions of people, so I don't understand why the Supreme Court would rule against it. I would have been very disappointed if they had."

A ruling invalidating subsidies would not only have caused massive disruption in the health insurance marketplace for consumers but also for marketplace insurers, including Dayton-based CareSource and Premier Health, according to Kev Coleman, head of research and data at HealthPocket.com.

"We would expect a certain portion of the public to drop out" of the marketplaces, Coleman said. "The question is how dramatically would that affect risk pools for insurers."

Coleman was referring to what's known in the health insurance industry as "adverse selection," or the tendency of low-risk, healthy individuals to drop insurance coverage when prices increase, while very sick and expensive-to-treat customers hold onto their policies because they have no other choice. That forces insurance companies to raise premiums to cover higher costs.

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