Takeaways From the Supreme Court Obamacare Ruling

Thursday, June 25, 2015

By Jim Knickman, President and CEO of New York State Health Foundation

This piece was originally published as a column on Huffington Post.

Living in a state like New York--where the Affordable Care Act (ACA) has successfully extended health insurance coverage to 2.1 million New Yorkers--I could only smile upon learning that the Supreme Court upheld the insurance subsidies for every state.

I can respect the strong opinions among many Americans who do not like this law. But at heart I am a pragmatist, and the facts show that many New Yorkers are really benefiting from the law, especially the most vulnerable.

Here are just a few of New York State's accomplishments so far:

  • More New Yorkers now have health coverage than ever before: 89 percent of New Yorkers who signed up for a health plan through the NY State of Health Marketplace were uninsured when they applied. In the first year of open enrollment, 72 percent of New Yorkers who enrolled in private plans through the Marketplace qualified for subsidies to help them afford coverage.
  • Medicaid is the bedrock of affordable coverage: Approximately three-quarters of New Yorkers who signed up on New York's Marketplace are now covered under Medicaid (the rest enrolled in private plans).
  • Most New Yorkers are happy with their coverage: 86 percent of New Yorkers covered through the Marketplace renewed their plans from year 1 to year 2. A survey last fall found that 92 percent of New Yorkers who became newly insured in year 1 are satisfied with their coverage.
  • New York's Marketplace is user-friendly: New Yorkers can browse the Marketplace website to find out about their options and estimated subsidies without having to register or commit to a plan, and this feature has been used by 2.4 million people. The website is available in both English and Spanish, and consumer materials exist in 18 languages.

Some experts felt that a ruling against the ACA by the Supreme Court would not affect New York, as we have a State-run insurance exchange. We may not have been affected in the short term, but a ruling against the ACA would likely have led to substantial changes in the law over the next two years that could have impacted our State's success to date.

We can now feel more confident that this historic legislation will go a long way toward decreasing health inequities -- including uneven access to care -- in New York and across our country. And making health care more affordable and accessible will help address a more fundamental challenge in our society: arresting the sharp and growing inequalities between the most fortunate and the most vulnerable in America.

Unfortunately, the job of health reform is not entirely done. We need to continue our efforts to extend coverage to and improve access to care for undocumented immigrants. Some ideas about how this might be done in New York are bubbling up among those who are insurance experts. Stay tuned!

Additionally, there remain too many other New Yorkers who have not achieved coverage; we should continue statewide outreach efforts for those who still are uninsured.

This is also a good moment to give a well-deserved "shout out" to the many State employees who have worked so hard over the past five years to make the ACA work in New York. Hats off to Donna Frescatore, Executive Director of the NY State of Health Marketplace, and to her dedicated staff members! They have a lot to be proud of, and they deserve our appreciation.

So let's enjoy this moment, and then continue the quest to make our nation's complex health care system work better and better. Coverage has expanded, but we've got other challenges to tackle if we want to make health care delivery more accessible and responsive not only for every New Yorker, but for all Americans.

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