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Central Texans' Obamacare Coverage Hinges on Supreme Court Decision

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Filipa Rodrigues/KUT News

The U.S. Supreme Court hears arguments today over part of the Affordable Care Act. It’s a case that could have an impact on hundreds of thousands of Texans who bought insurance on the federal marketplace.

It comes on the heels of the Obama Administration’s announcement last month that some people who bought insurance through the online marketplace were given tax forms with incorrect information about their coverage in 2014.

Still, some Central Texans are still trying to cut through the confusion, even as the health law’s future hangs in the balance.

Across the aisle from the food court in Highland Mall, some folks are doing some shopping. But they’re not comparing the prices on a pair of jeans or some new sunglasses. They’re trying to buy health insurance.

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Credit Filipa Rodrigues/KUT News

“That’s why we’re here, is that people really need assistance navigating this process,” says Elizabeth Colvin, director of a non-profit called Insure Central Texas. “Some of the questions, if you read them literally, you’re not going to get the right answer on the eligibility letter. And there are plenty of questions that are using ‘terms of art’ based on the tax code. So, if you don’t understand what they’re asking, you’re going to get the wrong results.”

Those wrong results might mean you to pay too much for your insurance, or even suffer a fine on your taxes if you can’t find a plan you can afford. Because that’s really the main rule of the Affordable Care Act: You’ve got to have insurance.

“What’s unpopular is the individual mandate to carry insurance and that’s what basically everyone knows about,” says Sam Richardson, a professor at UT’s LBJ School of Public Affairs. “Without it, the law basically doesn’t work.”

Richardson has a Ph.D. in health policy and teaches a class looking at the implementation of the Affordable Care Act.

But it’s the tax subsidies that help some people pay for insurance plan that are at issue in the case before the Supreme Court today.

The case revolves around four words in a law that’s hundreds of pages long. Challengers say that the words "established by the State" make clear that subsidies are only available to people living in the 16 states that set up their own insurance exchanges. Texas is one of the 34 that opted not to build its own – and instead relies on the insurance marketplace run by the federal government. Richardson admits even experts can’t tell what the court is going to do.

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Credit Filipa Rodrigues/KUT News

“It’s hard to say,” Richardson says. “It comes down to a question of whether the Supreme Court rules based on the literal reading of the words in the law or based on the intent of the people drafting the law. It’s pretty clear that they did not intend the subsidies to only be available on the state-based marketplaces.”

Regardless of what the Court does, if you’re without insurance for longer than three months, you’re going to pay a fine. Last year it was $95 or one percent of your household income. This year, the penalty would be $325 or two percent.

But in order to hopefully eradicate the mistakes on the tax forms, the Department of Health and Human Services created an extended enrollment period from March 15 through April 30 this year. They’re hoping more people sign up for healthcare so they can avoid the fine.

Veronica Rangel and her family were insured, so she didn’t pay a fine last year, and she doesn’t intend to do so in 2015. She was at Highland Mall with her mom and her sister to make sure they’ve got all their ducks in a row. She says they tried to do it themselves online, but after noticing a number of problems, they sought out some help.

“It’s something to follow up on, making sure that everything is corrected,” she says. “Because it was completely wrong. Not completely wrong, but there were errors.”

Rangel says she wants to keep her insurance, but she was surprised at the price tag even at her family’s income level.

“It’s pretty expensive, if you look at all the plans they have as far as the different types, it’s pretty costly,” she says. “It doesn’t seem like it’s really affordable.”

And without federal tax subsidies, it’s not going to get any cheaper.

If the Supreme Court strikes down the subsidies in states like Texas, it doesn’t necessarily void the law, it just changes the market for insurance.

An estimated 5 million people nationwide would no longer be eligible for subsidies.

That means fewer Americans, and Texans, are likely to be insured.

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