Home Health Insurance Landmark SCOTUS Rulings Impact Health Insurers

Last week was a busy week for the Supreme Court, which upheld the subsidy provision of the Affordable Care Act in King v. Burwell, and passed a landmark decision granting same-sex couples the right to marry in all 50 states. Each of these decisions will have a considerable impact on the health insurance industry; first and foremost, ensuring access to health insurance for a significant number of individuals.

In a 6-3 decision, King v. Burwell concluded that states did not need to establish their own health insurance exchanges, separate from the federal exchange, in order for its residents to qualify for federal subsidies. While this ruling will not significantly change the way insurance companies currently operate, it gives insurers a level of certainty to move forward. Rather than expending energy and resources on contingency plans, insurers can begin to focus on other projects to improve customer engagement and satisfaction.

With the Obergefell v. Hodges ruling, same-sex couples now have the right to marry in all 50 states and are guaranteed full spousal rights under the law. The impact to health insurers will be substantial, as businesses and states that did not provide same-sex partner benefits will now need to do so for spouses. Currently, only half of employers who offer healthcare benefits extend those benefits to partnerships, and only 37 states recognized same-sex marriage prior to the Supreme Court decision.

With these historic rulings front and center in the national conversation, it is an opportune time for health insurers to reach out to their prospective customers, current members, and employers. The subsidy ruling could be an excellent touchpoint for insurance companies to communicate the validity and permanency of the Affordable Care Act. With approximately 10% of the population still uninsured, it is important to provide helpful guidance and highlight the importance of insurance to this population.

Prospective Customers: Smart insurers are proactively reaching out to uninsured populations and the LGBT community to provide advice on what these rulings mean for coverage, enrollment, and other critical questions. This is a timely moment for insurance companies to connect with potential customers and reinforce the importance of health insurance – and the fact that subsidies are not at risk for those who may qualify.

Existing Members: Existing members in newly-recognized marriages may have many questions as to how the Supreme Court ruling affects their coverage. In addition to communicating relevant changes, this is an opportunity to offer value to your members, with tools and information that explain key points such as plan options, and whether adding a spouse affects their subsidy eligibility.

Employers: For organizations that extend health coverage to employees, these rulings may create some initial confusion. Your group customers may need assistance in interpreting the differences between partner and spousal benefits, and the implications of offering one or the other. Employers will also need guidance to understand how different state and federal regulations impact them. For example, can the state continue to offer partner benefits only to same-sex couples if they can now legally marry?

Last week’s Supreme Court rulings mark a major milestone for the health insurance industry; most significantly, granting access to healthcare for a larger part of the population. At the same time, it’s important to get this right. As prospective and existing members begin to ask questions about how this impacts their specific situation, insurers have an opportunity to be proactive, provide assistance, and ultimately, bolster their reputation as a trusted source for healthcare information.

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