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Wednesday, July 23, 2014

What Obamacare’s dueling rulings mean: A NH explainer

CONCORD – A Washington, D.C.-based federal appeals court ruling puts at risk taxpayer-paid subsidies given so low- to
moderate-income families can better afford health care from federally run health exchanges in New Hampshire and 33 other states.

But several veteran court observers predict that a contrary decision from a federal appeals court in Richmond, Va., a few hours later Tuesday means the U.S. Supreme Court will end up settling this constitutional dispute. ...

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CONCORD – A Washington, D.C.-based federal appeals court ruling puts at risk taxpayer-paid subsidies given so low- to
moderate-income families can better afford health care from federally run health exchanges in New Hampshire and 33 other states.

But several veteran court observers predict that a contrary decision from a federal appeals court in Richmond, Va., a few hours later Tuesday means the U.S. Supreme Court will end up settling this constitutional dispute.

That final judgment and the potential fallout for working families could extend well beyond November’s general election.

Sen. Jeanne Shaheen, D-N.H., and Gov. Maggie Hassan, both supporters of the Affordable Care Act, said they were confident that courts ultimately will agree that these tax subsidies should be available to all in the U.S., whether the state has its own exchange or not.

Senate Republican rival Scott Brown said the initial ruling means these working families will have to pay more out-of-
pocket for coverage or state taxpayers may have to bail them out.

New Hampshire finds itself in the center of this controversy after the Republican-led Legislature passed two state laws flouting Obamacare.

The one in 2011 prevented the state from forming its own exchange meant to fulfill the Obamacare mandate that all individuals have to purchase health insurance or eventually pay a tax penalty.

They followed it with a 2012 law that kept state insurance regulators from working directly with Washington as the Obama administration set up a federally run exchange to insure people here.

The latter law did permit a state “partnership.’’

Over the objection of Republican legislative leaders, Hassan in early 2013 directed that the New Hampshire Health Plan – operators of a high-risk pool – would get a $5.3 million federal grant to work with federal officials on consumer education and outreach.

These subsidies are for families of four making up to $94,000 and can dramatically reduce out-of-pocket costs for their premiums.

As politicians on both sides try to score points, families already in New Hampshire’s federally run exchange will anxiously watch the calendar.

That’s because premium rates they would pay to continue to get health care through these exchanges in 2015 are expected to become public around mid-November.

If a final court judgment doesn’t come by then, these families could face the sticker shock of signing up at one bottom-line rate for 2015 only to learn in the months to follow that they could have to pay much more than they thought.

Meanwhile, this court fight has no impact on Medicaid expansion, set to start Sept. 1, when up to 50,000 low-income adults become eligible for government-paid health insurance.

That’s because these adults eligible for expanded Medicaid earn less income – no more than 138 percent of the federal poverty level, or $16,000 a year for an individual – than those who under the federal law can receive the subsidies.

Kevin Landrigan can reached at 321-7040 or klandrigan@nashuatelegraph.com. Also, follow Landrigan on Twitter (@Klandrigan).