San Angelo health officials back ACA ruling

June 26--The U.S. Supreme Court's ruling to uphold nationwide tax subsidies under the Affordable Care Act has support in San Angelo.

"This is really a good thing," said Shane Plymell, chief operating officer at Shannon Medical Center.

The ruling will help provide greater access to health care and encourage more people to take advantage of affordable insurance, he said.

The lawsuit against the national health care law argued millions of consumers in 35 states who did not set up their own exchanges and instead relied on the federal government's healthcare.gov should not receive tax credits to pay premiums.

Thursday's 6-3 ruling affected millions of Americans regardless of where they live and will ensure qualified individuals with household incomes between 100 percent and 400 percent of the federal poverty line have access to affordable insurance through tax credits.

Plymell said Shannon has not had many patients enrolled with a marketplace insurer, but he hopes to see that change -- especially after the court's decision.

If the decision had gone against the health care law, Plymell said patients seeking treatment would have been greatly affected.

It's less costly for patients to visit outpatient care clinics and seek preventive care before a real emergency arises, which in the long run can keep costs down by limiting visits to the emergency room, he said.

"Our hope is more and more people get coverage through the (Affordable Care Act)," he said.

As of February, San Angelo had 2,991 people enrolled through the federal marketplace in several plans offered by three insurers: Assurant, Blue Cross Blue Shield of Texas and Scott and White Health Plan.

The subsidies for individuals are not known, but data obtained by The Associated Press indicated that 86 percent of Texas residents who have enrolled with ACA insurers through the federal exchange received subsidies averaging $247 per month.

If those averages are applied to the number of enrollees with San Angelo ZIP code addresses, the total annual subsidy granted to local residents would be about $7.625 million. The tax credits are paid directly to the insurer.

Jeremy Riney, CEO of San Angelo Community Medical Center said: "We are pleased that the U.S. Supreme Court upheld tax subsidies for citizens who purchase insurance on the federally facilitated health insurance marketplace, or exchange. These subsidies provide vital assistance for some of our state's most vulnerable citizens so they can afford health insurance.

"Comprehensive insurance enables these citizens and families to receive preventive care earlier and in less expensive settings, which benefits patients, providers and insurers -- as well as our economy -- by reducing overall health care costs. Continuing these subsidies helps patients obtain coverage for the care they need and ensures hospitals are reimbursed for the essential services they provide, making our nation's health care system stronger, benefiting everyone."

Mike Campbell, CEO at Esperanza Health and Dental Centers, said the court's decision will not affect patients.

Had the subsidies not been upheld, he said patients would have had significant issues being able to afford premiums.

It's likely that the clinic would have seen an increase in the number of self-pay patients inheriting out-of-pocket costs, he said.

Esperanza offers services including general primary medical care, laboratory services, dental care and gynecological care to patients -- many of whom are enrolled in the government-run marketplace.

The clinic provides health care services to about 10,000 patients a year, Campbell said, estimating that face-to-face patient encounters average about 40,000 a year if each patient is seen about four times a year.

Esperanza acted as a go-to resource for San Angelo residents who were interested in signing up for health care through government run marketplace when it was enrolling people in 2013. There was "a tremendous interest in people wanting to enroll," he said, echoing Plymell's belief the Supreme Court's decision was the right one for patients.

"It's just an affirmation of the constitutionality and legitimacy of the Affordable Care Act," he said. "More people can have access to health care and utilize insurance made available to them, and if they qualify for subsidies it will help pay premiums."

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