Wilson joins fight against health care subsidies

A U.S. Supreme Court case will decide if health insurance customers in South Carolina and more than 30 other states may use federal subsidies to help pay for their coverage.

If South Carolina Attorney General Alan Wilson has his way, health insurance shoppers in this state won't qualify for federal subsidies to offset the cost of their coverage. Millions of dollars that low- to middle-income customers use to pay for insurance could vanish.

In a brief filed with the U.S. Supreme Court late last month, Wilson joined top prosecutors in Alabama, Georgia, Oklahoma, Nebraska and West Virginia, pledging their support for plaintiffs in a case called King v. Burwell, which will be heard before the high court this spring.

They argue that federal subsidies made available through the Affordable Care Act may only be used by residents in states that set up their own insurance marketplaces. The law clearly explains this, they argue, but the Internal Revenue Service has misinterpreted the rule.

South Carolina, and more than 30 other states, rejected the option to create a state-based marketplace. Instead, they chose to use the federal marketplace - HealthCare.gov. Residents in the "HealthCare.gov states" may become ineligible for any discounts, depending on the court's decision.

Wilson was unavailable to be interviewed on Monday, his spokesman said, but he issued a prepared statement.

"I am pleased the U.S. Supreme Court has agreed to hear this important case. As I previously said when I joined with five fellow Attorneys General in filing an amicus brief, it's important that we stand up whenever unelected bureaucrats, like those at the IRS, attempt to administrate what Congress did not legislate. We are hopeful the Supreme Court will provide much needed clarification to the 36 states which refused to establish state-based health care exchanges under the Affordable Care Act."

The New York Times reported this weekend that relatively few Republican state officials joined Wilson and his colleagues in support of their brief. Stripping subsidies from millions of voters could prove politically unpopular, even among Republicans, who have long pushed back against the federal health care law.

Many people are happy with their new coverage, and particularly happy about the price they pay for it.

Federal data shows more than 75,000 South Carolinians enrolled in an Affordable Care Act insurance policy during the first month of open enrollment, which started Nov. 15. Nearly 90 percent of them qualified for a federal subsidy to help pay for their coverage.

For some low-income customers, the subsidies reduce the cost of monthly premiums from hundreds of dollars to less than $10. Others receive more modest discounts.

If the Supreme Court decides to restrict those subsidies to the state-based marketplaces, shoppers in South Carolina would suffer, said Shelli Quenga, programs director for the nonprofit Palmetto Project.

"There's no way that most people would be able to afford it. It's competing for housing dollars and food dollars and gas dollars and family budgets," she said. "It's kind of all up in the air, in a way."

Reach Lauren Sausser at 937-5598.