Legal and political experts will be discussing the ramifications of the Supreme Court’s historic ruling in King v. Burwell for months to come, but the case’s impact is purely personal for 6.4 million people in 34 states.
Many of these individuals are currently battling chronic disease and will continue to receive the tax credits that help them afford the health plan they bought in the federal marketplace. Losing the tax credits made possible by the Affordable Care Act could have forced them to drop coverage, ending their ability to get needed care.
Millions of families would likely have seen their premiums rise as healthier people abandoned the federal marketplace rather than pay more out of pocket, leaving only those with chronic diseases and other major medical problems.
As organizations representing tens of millions of people nationwide with serious chronic conditions, we strongly agree with the court’s decision that tax credits should be available to all eligible Americans, whether they bought their health plan in a state marketplace or the federal marketplace.
Our position is based on the heartbreaking stories we heard before the health care law took effect — stories from patients who were denied health coverage outright because of their health condition, who had to pay sky-high prices for coverage they could get or who ended up with plans that proved inadequate for a major diagnosis.
As evidence-based organizations, we are equally compelled by numerous scientific findings that link one’s insurance status and their chances of surviving cancer, diabetes, heart disease, multiple sclerosis or stroke. In our friend-of-the-court brief filed in January, we cited peer-reviewed studies establishing that the uninsured are more likely than people with insurance to be diagnosed with advanced-stage chronic conditions and to suffer the worst consequences of their diagnoses. For example:
• The uninsured are more than four times as likely as those with health coverage to be diagnosed with late-stage breast cancer, and 1.4 times as likely to be diagnosed with advanced-stage cervical cancer.
• Uninsured patients with stage 4 colorectal cancer are nearly four times as likely as patients with private insurance to go without cancer treatment altogether.
• Uninsured patients with cardiovascular disease experience higher mortality rates and poorer blood pressure control than the insured.
• Uninsured people who suffer the most common type of stroke have greater neurological impairments, longer hospital stays and up to a 56% higher risk of death than people with insurance.
• Patients without health insurance are twice as likely to have a diabetic complication as patients with health insurance.
Patients need high-quality health insurance to help pay the substantial costs of treatment and care. Without coverage, the costs of treating chronic diseases are far beyond the reach of most Americans, particularly working families who can face insurmountable medical debt shortly after a serious diagnosis.
For example, our research found that the average cost of disease-modifying treatment for MS is $62,000 per year. Treatment for cardiovascular disease was a leading cause of medical bankruptcy before the Affordable Care Act went into effect, with strokes costing patients more than $23,000 in out-of-pocket medical costs and heart disease costing patients nearly $22,000.
The medical costs paid by people with diagnosed diabetes are 2.3 times higher, on average, than the costs paid by people without diabetes. The average medical debt of colon cancer patients is nearly $27,000, and cancer patients overall are more than 2.5 times as likely to file for bankruptcy as people who do not have cancer.
No family should have to fight a serious chronic condition on their own. Virtually no family can. Now that the Supreme Court has interpreted the law as Congress intended, millions of people who have gained health coverage will be able to maintain it, to the benefit of their physical and financial health. It is long past time to turn the nation’s attention from tearing down the ACA’s patient protections to ensuring every American has access to quality, affordable health coverage.
