Texans Could Lose Subsidies To Help Pay for Health Care

Debbie Townley of Austin is one of nearly 1 million Texans who could lose the financial assistance she gets to help pay for health insurance if the Supreme Court rules against the Obama administration.
Alexa Garcia-Ditta
Debbie Townley of Austin is one of nearly 1 million Texans who could lose the financial assistance she gets to help pay for health insurance if the Supreme Court rules against the Obama administration.

Debbie Townley, a 54-year-old grandmother of two living in Austin, didn’t get annual mammograms or well-woman exams for years because she couldn’t afford health insurance.

“I would go to the emergency room to get health care to take care of an ailment,” she said. “It got to the point where I would be sick and still be going to work because I couldn’t go to the doctor.”

But in February, she found a solution. Townsend signed up for a plan through the Affordable Care Act’s insurance marketplace. After a $194 subsidy, Townley only pays $158 out of her pocket each month. She can now afford regular checkups and cheaper prescriptions.

Townley’s subsidy and that of nearly 1 million Texans who purchased health insurance and also qualify for financial help through the federal marketplace are in jeopardy. Yesterday, the U.S. Supreme Court heard oral arguments in a challenge to a portion of the Affordable Care Act, better known as Obamacare. At issue is whether people who live in states that did not set up their own state-administered insurance marketplaces, including Texas, are eligible to receive federal tax credits. Should the high court rule against the Obama administration, Townley and other Texans who qualify for a federal subsidy could lose the money they get to help pay for health insurance.

“Without the tax credit, it’d be really hard to pay my bills,” she said. “To do away with the tax credit would be another burden on my finances.”

As oral arguments wrapped up Wednesday in Washington, D.C., state Rep. Chris Turner (D-Arlington) filed two bills that he says will protect Texans who receive federal subsidies. House Bill 817 would create a Texas-run exchange if the Supreme Court decides consumers in Texas aren’t eligible for tax credits through the federal marketplace. House Bill 818 would create a state exchange regardless of the outcome.

For the last several sessions, Texas lawmakers have decided against establishing a state-administered exchange.

“Texas needs to be prepared,” Turner said. “I understand that many of my colleagues in the Capitol do not support the [Affordable Care Act], but what I do hope, however, is that people will see through political rhetoric and agree that making sure our constituents don’t get hit with a major tax increase is the right thing to do, as well as ensure that Texans who have purchased health plans in the marketplace have the ability to keep them and get the health care that they and their families need.”

During the last open enrollment period, which ran from October to mid-February, almost 1.2 million Texans enrolled in health plans through the federal marketplace. Of those, 84 percent qualified for a subsidy that lowered their monthly payments.

To receive a federal tax credit, an individual must earn between $11,500 and $46,680, or between $25,850 and $95,400 for a family of four. The Kaiser Family Foundation, a national health care research organization, estimates that more than 2 million Texans are eligible to receive financial assistance, though not all of them are currently enrolled. According to the National Women’s Law Center, nearly 1.3 million of those eligible are women and approximately 761,000 are Hispanic.

Texans at risk of losing their insurance aren’t the only ones worried. Ted Shaw, CEO of the Texas Hospital Association, said Texas hospitals incur billions of uncompensated care costs by treating the uninsured in emergency rooms.

“An end to tax subsidies and private health insurance coverage for nearly 1 million Texans will further weaken the already strained health care safety net and increase the un-reimbursed care costs shifted on to employers and property taxpayers,” he said.

Early analysis of oral arguments by legal experts indicate the justices could be split 5-4, though it’s unclear what the outcome will be. Though Texas isn’t challenging the Affordable Care Act in this case, Attorney General Ken Paxton said in a statement that the lawsuit “will ultimately free Texans from the bureaucratic burdens of this unjust, unaffordable and failing law.”

A decision is expected by June.

Alexa Garcia-Ditta is a staff writer (and former intern) covering women's health, reproductive health and health care access.

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Published at 7:30 am CST