S.C. patients’ premiums might quadruple

Health insurance shoppers who use HealthCare.gov may not qualify for federal subsidies if the U.S. Supreme Court rules in favor of the plaintiffs in the upcoming King v. Burwell case.

Cathy Keaton’s health insurance premium will jump nearly $400 each month if the U.S. Supreme Court rules that she’s ineligible for a federal subsidy to lower the price she pays.

The 63-year-old part-time College of Charleston student said she couldn’t afford coverage without the substantial discount she receives.

“It’s very scary for me,” Keaton said. “If I lose this, it means that I will have to make some really hard decisions until I can get Medicare.”

She’s not alone. Insurance premiums for thousands of HealthCare.gov customers in South Carolina could increase by 400 percent if the U.S. Supreme Court rules that they’re ineligible for subsidies this summer.

A new analysis by Avalere Health, a national health care company, shows premiums in this state may triple or quadruple, pending the high court’s decision in the upcoming King v. Burwell case.

“People wouldn’t be able to afford the health care,” said Wilma Holman, who works for the Beaufort Black Chamber of Commerce and helped residents sign up for Affordable Care Act coverage during open enrollment.

Palmetto Project, a Mount Pleasant nonprofit, estimates eight of every 10 customers they helped enroll in coverage qualified for a subsidy this year.

The legal arguments the Supreme Court justices will hear on Wednesday are complex. Affordable Care Act opponents who brought the lawsuit say the law’s literal wording only allows the government to pay subsidies in states that have set up their own insurance markets, or exchanges. Most states, including South Carolina, have not. Supporters of the law say such a narrow reading misses its basic intent: to increase Americans’ access to health insurance nationwide.

A potential premium increase would hit almost every HealthCare.gov shopper — specifically, the ones who qualify for federal subsidies to reduce the price they pay for insurance. In South Carolina, Department of Insurance data shows more than 195,000 insured people in this state who have enrolled in an Obamacare policy already receive those subsidies.

Avalere Health estimates 7.5 million Americans could face an average 225 percent premium increase if the court decides subsidies may not be used on HealthCare.gov.

“The federal exchange generally serves low-income populations in red states, so that’s where the premium increases would be concentrated,” said Avalere Health CEO Dan Mendelson, in the report. “If King prevails, we expect to see virtually all stakeholders aggressively seeking alternatives to ensure continuity of care.”

If the court rules in favor of the plaintiffs in this case, residents in Alaska and Mississippi will likely see the highest premium increases, Avalere projects.

Some states will not be affected. Residents in states that set up their own state-based health insurance marketplaces will continue to qualify for subsidies no matter what the court decides.

“The governor and the Legislature of this state made the decision ... not to establish a state exchange,” said Department of Insurance Director Ray Farmer, a member of Gov. Nikki Haley’s cabinet. “They thought it was the right decision then. They think it’s the right decision now.”

Haley’s spokeswoman has previously said the governor is sticking by her original decision, even though members of a committee she established to analyze the issue four years ago told The Post and Courier that they were unaware these subsidies were at stake.

A Gallup poll released this week shows the uninsured rate in the United States dropped from 17.3 percent in 2013 to 13.8 percent at the end of 2014. In South Carolina, the rate dropped from 18.7 percent to 15.4 percent.

The Associated Press contributed to this report. Reach Lauren Sausser at 937-5598.