Tax subsidies helped over 400,000 in tri-state area get health insurance

photo President Barack Obama's signature healthcare law received a setback and affirmation in two appellate court rulings issued within hours of each other Tuesday. Obama is shown here speaking in Washington on Monday.

BY THE NUMBERSTennessee:• 151,352 people picked marketplace plans.• 120,565 of those (80 percent) were eligible for subsidies.Georgia:• 316,543 people picked marketplace plans.• 275,378 of those (87 percent) were eligible for subsidies.Alabama:• 97,870 people picked marketplace plans.• 83,348 of those (85 percent) were eligible for subsidies.Source: U.S. Department of Health and Human Services, Planning and Evaluation Marketplace Summary Enrollment Report

READ MOREDueling rulings: Courts split on health law clash

More than 120,000 Tennesseans who bought health insurance plans off the new federal marketplace this year - 80 percent of those who bought such plans - made the purchase with the help of federal tax credits.

Nearly 275,000 Georgians bought plans that included subsidies, as did 83,000 Alabamians who selected plans off the federal marketplace.

Now, as the long-term validity of those subsidies is called into question by dueling federal court rulings issued Tuesday, health experts said the impact on states like Tennessee, Georgia and Alabama will remain unclear until a higher resolution is reached - likely through the Supreme Court.

Meanwhile, Tennessee's largest insurer said it was moving forward with its strategy to offer a wide variety of plans on the marketplace, enrollment advocates pushed a business-as-usual attitude for upcoming enrollment, and Tennessee Republicans used the opportunity to condemn the law's flaws.

Tennessee Gov. Bill Haslam said Tuesday that it's "probably a little preliminary" to tell what impact two opposing rulings on Obamacare subsidies will have in the state.

"Two courts said opposite things. It'll wind up in the Supreme Court sooner rather than later," Haslam said.

Vanderbilt University Professor James F. Blumstein, who is also director of the university's Health Policy Center, said Tuesday that until that happens, subsidies in Tennessee will more than likely continue. But what happened Tuesday raises questions about the months ahead.

"Eventually, if the Supreme Court agrees with the D.C. circuit - and I do think the Supreme Court will eventually hear this case - it will mean that Tennessee will not qualify for subsidies, because we're using the federal exchange."

Tennessee, Georgia and Alabama were three of 34 states that decided not to create their own online marketplaces for insurers to sell subsidized insurance. Instead, the states opted to have their citizens use the federal marketplace.

Haslam said that states were rushed to make the decision about creating their own marketplace, or "exchange," and that Tennessee just decided that the issue was best left in the federal government's hands.

He also said since then, the 14 states that created their own exchanges have had mixed experiences - some "rolled it out effortlessly" while others had "major debacles."

BlueCross BlueShield of Tennessee, which sold 88 percent of the plans on the marketplace this year, indicated it was moving forward with developing its marketplace plans.

"Until a final decision is made, BlueCross BlueShield of Tennessee is carrying forward with offering the largest variety of health plan options on the marketplace to help ensure access and affordability to health care services for our fellow Tennesseans," spokeswoman Mary Danielson said on Tuesday.

This is how insurers across other states will likely respond, Blumstein said. But because the Washington, D.C., district court - which ruled against the subsidies- "carries a lot of weight," it would be "ostrich behavior" for insurance companies not to be considering twists and turns ahead.

Health advocates in the state also were moving ahead with efforts to reach uninsured Tennesseans.

Jacob Flowers, director of the Tennessee chapter of Get Covered America, said Tuesday's decision changes nothing for the organization's work to spread the word about "financial help that continues to be available" to Tennesseans.

Michele Johnson, executive director of the health advocacy group Tennessee Justice Center, said that the Halbig v. Burwell decision is "misguided."

"For the first time these families are able to access health care that is affordable, thanks to premium subsidies. That peace of mind is what they will lose if this decision is not corrected," she said.

Some Tennessee Republicans took the opportunity to continue to slam the health law.

"Today's decision is yet another blow to the president's disastrous health care law," said Rep. Diane Black in a statement. "If this decision holds, it means that the Obama administration has been doling out billions of dollars in taxpayer subsidies without the proper statutory authority."

Asked about what may happen to the 120,000 Tennesseans who signed up for subsidized plans in such a scenario, Haslam said, "I think that's a legitimate human concern that we'll have to wait and see how that plays out and how we handle that."

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.

Contact staff writer Andy Sher at asher@timesfreepress.com or 615-255-0550.

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