Killing the Patient Protection and Affordable Care Act (PPACA) premium subsidy in the states with federally run PPACA exchanges could reduce exchange plan use by 70 percent in those states in 2015, to about 4.1 million.
Evan Saltzman and Christine Eibner, analysts at the Rand Corp., have given that estimate in an analysis of the possible effects of a pending U.S. Supreme Court case on the public exchange system.
The court is preparing to hear oral arguments on King vs. Burwell (Case Number 14-114) in March. The plaintiffs in that case contend that only states with state-based PPACA exchanges can offer the tax credits that PPACA provides for exchange users with incomes between 138 percent and 400 percent of the federal poverty level.
A three-judge panel at the D.C. U.S. Circuit Court of Appeals ruled 2-1 in July 2014 that PPACA makes the subsidy tax credit available only through state-run exchanges.