Subsidies should not be restricted to health insurance marketplaces

The U.S. Court of Appeals for the Fourth Circuit and the D.C. Court of Appeals issued contradictory rulings on the legality of health care subsidies under the Affordable Care Act. When it comes to the ACA, at least we can all agree on one thing: It’s complicated.

NAIFA has long argued that Americans eligible for health care subsidies should not be restricted to the government marketplaces, and last fall the Centers for Medicare and Medicaid Services rightly agreed that consumers were allowed to obtain coverage outside of the exchanges. Today, the D.C. Circuit Court of Appeals ruled that tax credits under the ACA may be given only to those who reside in states that set up their own marketplaces. Following that decision was the 4th Circuit Court of Appeals’ ruling that the Administration could allow the subsidies nationwide regardless of the exchange model.

NAIFA President John F. Nichols has this to say about the rulings:

“If the goal of the ACA is to provide Americans with affordable health care coverage, then it only makes sense for those who are eligible for subsidies to be able to use the subsidies no matter where or how they obtain coverage. The news today reflects yet another glitch involving the ACA, but these ‘glitches’ hurt those who are most in need of health insurance: lower income Americans.

“Since the launch of healthcare.gov last fall, NAIFA members have stepped in to help consumers navigate the complicated world of health insurance. NAIFA members come from communities all over the country and from various social, ethnic and religious backgrounds. These agents are hard-working professionals dedicated to helping American families protect their financial security. As the ACA continues to evolve, agents are needed now more than ever to help individuals and small business owners understand how the myriad changes in the ACA potentially will affect them.”


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