RENEE MONTAGNE, HOST:
In just a couple of months, the Supreme Court will rule in a major case concerning the Affordable Care Act. The question is whether the law allowed for federal subsidies only in the minority of states that set up their own insurance exchanges, or if the law includes the majority of states that left the job of setting up exchanges to the federal government.
DAVID GREENE, HOST:
And this could be a big deal. About three dozen states have exchanges created by the federal government. Taking away subsidies in those states could leave millions without insurance.
MONTAGNE: For more, we reached Jeff Cohen of member station WNPR. He's spoken to people who rely on federal subsidies under the Affordable Care Act and joined us to talk about what they had to say. A warning - what you're about to hear contains language some might find offensive.
JEFF COHEN, BYLINE: Hi, Renee.
MONTAGNE: There's been a fair amount of coverage about the case before the Supreme Court, but remind us exactly what's at stake here.
COHEN: Sure. The act does a lot of things, but one of the big ones is mandate that all Americans get health coverage or pay a penalty. So to help coax people to get that insurance, the federal government is subsidizing premiums for millions of Americans. But opponents say those subsidies are only for states that didn't use healthcare.gov. Attorney Tom Goldstein's been following the case.
TOM GOLDSTEIN: This is a real serious question. The law is ambiguous. It doesn't tell you whether Congress wanted to limit the subsidies only to those states where the state itself went to the trouble of setting up the exchange or whether Congress wanted everybody who needed the help to be able to get the subsidies.
COHEN: So that got us thinking, who are the people getting the subsidies, and who stands to lose them?
MONTAGNE: And you went down to Louisiana. And out of all the three dozen or so states on healthcare.gov, why that state?
COHEN: Well, the state is on healthcare.gov, where about 186,000 people have gotten health insurance, and nearly 90 percent of those people in Louisiana get subsidies.
MONTAGNE: Tell us who you met.
COHEN: I met a man named Carlton Scott. He's 63. And we sat at his kitchen table at the house he owns in a town called Prairieville. And he told me he worked at a chemical plant for 30 years before he retired, but now his company's scaling back his retiree benefits, including his health insurance, and that's something he was really counting on.
CARLTON SCOTT: Around October, they wrote me a letter saying in December, they'll no longer have me covered.
COHEN: Was it always your thought that, look, when I retire, I'm going to be covered? Was that how you thought about it?
SCOTT: I thought they would take me to my grave. I really thought the company would take me to my grave.
COHEN: When your company said, we're going to cancel your health insurance...
SCOTT: That pisses me off. I've been through 30 years and you come with this [expletive].
MONTAGNE: So you said he's 63, which would make him too young for Medicare. Obamacare then must've seemed like a great option.
COHEN: Obamacare's a great option for him.
SCOTT: I got Blue Shield Blue Cross of Louisiana.
COHEN: Do you know what - roughly what you pay a month?
SCOTT: Yeah, exactly to the penny.
MONTAGNE: To the penny, he really knows.
COHEN: He does. That's something I heard from a lot of people, too. Money's tight, and they know exactly what they're paying.
MONTAGNE: Which gets us to the possibility that Mr. Scott could lose his subsidy on his health insurance.
COHEN: That's right. And he said if he had to pay more, he could for a while. And he says it was the talk of the town when he and his colleagues got those letters canceling their health insurance. And now he's worried about his friends.
SCOTT: Everybody don't make the same amount of money. I got a friend of mine staying down the street. He gets Social Security and pension, too, but it's not as much as mine - not half as mine.
COHEN: The judges on the Supreme Court are considering a very technical question.
SCOTT: They all got insurance, too (laughter). I guarantee you that.
COHEN: Let's say they were sitting here. What would you say to them?
SCOTT: Leave it like it is. What people going to do?
MONTAGNE: Now, who else did you meet?
COHEN: I met a woman named LaTasha Perry. She's 31, and she works at the front desk of a community health center in Plaquemine, La. She got covered under Obamacare because it was cheaper than paying the penalty. She says her children are on Medicaid. But while her job offers her health insurance, she doesn't buy it. She's like a lot of those people who work but don't make a lot of money. She says she can't afford it.
LATASHA PERRY: I would pay at least $100 a month for the insurance here.
COHEN: And what is Obamacare?
PERRY: With my subsidy, I pay $13.
COHEN: And now, she says, she's got money left over for her family.
PERRY: Food for my kids. I'm a single parent, so it's hard.
MONTAGNE: And, Jeff, I gather you also went up to Shreveport and met people there.
COHEN: I did. I met a man named Charles Dalton. And he's different from Perry because he actually wanted the coverage. He's 64. After he retired as a paramedic, he didn't have health insurance, but then he got sick. He says his condition is too personal to talk about.
CHARLES DALTON: I would be totally incapacitated without seeing this doctor.
MONTAGNE: And, of course, Obamacare won't allow insurers not to accept somebody even if they're sick, like this gentleman.
COHEN: Exactly. That used to make insurance unaffordable for many sick people. And now with Obamacare, Dalton says he pays $149 a month. And he hopes that the Supreme Court doesn't touch the subsidies.
DALTON: They just going to make a difficult situation more difficult. If you get a helping hand, the last thing you need is for it to be snatched from under you.
COHEN: So, Renee, regardless of the politics, there are a lot of people like Dalton who fear the Supreme Court would be taking something away. Tom Goldstein, the attorney we heard from a few minutes ago, says the court has a tough job - balancing the law with the human dimensions of the case.
MONTAGNE: And that is Jeff Cohen. He's a reporter with WNPR in Connecticut. He traveled to Louisiana to talk to people about Obamacare subsidies. He comes to us as part of a reporting partnership with Kaiser Health News. Thanks very much.
COHEN: You're welcome.
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