Dueling Court Rulings: What's Next for the Law

Kaiser Health News' Mary Agnes Carey answers several questions raised by Tuesday's conflicting court decisions on the Affordable Care Act's subsidies and how they may affect consumers.

Question: I live in a state with a federally run exchange (this is 36 states, including Pennsylvania, New Jersey, and Delaware) and I get a subsidy to help me buy coverage. Am I going to lose it?

Answer: Nothing is happening immediately. Justice Department officials said Tuesday they plan to seek an en banc review from the D.C. Appeals Court, meaning that the panel's full contingent of 11 judges would hear the case. Six of the court's judges would have to agree for the full panel to review the case. The full panel is dominated by judges appointed by Democrats, 7-4.

Eventually the case could be considered by the Supreme Court, but the current subsidies would likely remain in place until there is a final legal decision on the matter.

"In the meantime, to be clear, people getting premium tax credits should know that nothing has changed; tax credits remain available," said Emily Pierce, deputy director of the Justice Department's office of public affairs.

Q: Are these the only two court cases?

A: No. There are two other similar cases pending in courts in Oklahoma and Indiana.

Q: If there are legal disputes ongoing about who qualifies to receive a subsidy, do I still have to buy health insurance?

A: Yes. The law's "individual mandate," which requires most people to purchase health insurance or pay a fine, is still in place.

Q: What if I get my insurance through work?

A: This decision applies only to policies sold on

the online marketplaces. It does not affect work-based insurance, Medicare, or Medicaid, regardless of where you live.

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