Supreme Court Upholds Affordable Care Act Subsidies; Important Victory for HIV-Affected Communities

In a 6-3 decision in King v. Burwell, the United States Supreme Court rejected the latest challenge to the Patient Protection and Affordable Care Act (ACA), declaring that health insurance subsidies are available to residents of all states.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them[,]” the Court stated in the opinion authored by Chief Justice Roberts. “[The tax] credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid.”

Scott Schoettes, HIV Project Director for Lambda Legal, said:

“This is great news. The majority ruled to preserve the tax credits and maintain the integrity of the Affordable Care Act, protecting access for all, including people living with HIV who are low-income, rural, southern, Black, and were—before the Affordable Care Act—largely uninsured. No one should be put at greater risk to the ravages of HIV simply because they live in one of the 34 states choosing not to set up its own health insurance exchange."

Greg Nevins, Lambda Legal Counsel, said:

“When Congress enacted the ACA in 2010, only 17% of people living with HIV had private health insurance—a disheartening statistic given the greatly improved health outcomes and dramatically reduced likelihood of transmission when people have access to consistent care. Today, the Court acted to preserve a key component in the battle against HIV/AIDS—improved access to affordable, reliable and comprehensive healthcare, an especially critical need for vulnerable communities of color,” Lambda Legal Counsel Greg Nevins said.

Last January, Lambda Legal filed a friend-of-the-court brief on behalf of nine national HIV advocacy organizations focusing on how an adverse decision in the case would most severely impact people of color living with HIV in the states that have elected not to run their own health insurance exchange. 

The Affordable Care Act, signed by President Obama in March 2010, reformed aspects of the healthcare and insurance system and expanded access to private health insurance for millions of Americans. In King v. Burwell, opponents of the ACA—which is providing access to healthcare for millions of previously-uninsured Americans—attempted to eliminate tax credits that make health insurance affordable for most low-income residents in the 34 states that have a federally-facilitated health insurance exchange, including tens of thousands of people living with HIV. The lawsuit jeopardized access for those earning between 100%-400% of the Federal Poverty Level ($23,850-$95,400 for a family of four) to the subsidies that allow them to afford health insurance and maintain their health. The IRS ruled that the tax credits are available to participants on the health insurance exchanges in every state, but the challengers wanted to limit the tax credits only to residents of states that established and are administering their own health insurance exchanges.

The following organizations joined Lambda Legal as signatories in the amicus brief: Asian and Pacific-Islander Coalition on HIV/AIDS (APICHA), Black AIDS Institute, Gay and Lesbian Advocates & Defenders (GLAD), GLMA: Health Professionals Advancing LGBT Equality (GLMA), HIV Prevention Justice Alliance (HIV PJA), Latino Commission on AIDS, National AIDS Education and Services for Minorities (NAESM), National Black Justice Coalition (NBJC), and National Minority AIDS Council (NMAC).

Lambda Legal Counsel Greg Nevins and HIV Project Director Scott Schoettes joined Kristen Mayer, Nicole Cate, Douglas Hallward-Driemeier and Nicholas Perros of Ropes & Gray LLP as counsel on the brief.

Read the press release.