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What Hawaii Residents Should Know About the King v. Burwell Obamacare Case

Hawaii Health Care Subsidies Stabilized By U.S. Supreme Court: King v. Burwell

The U.S. Supreme Court has decided that Obamacare subsidies are legal for all states.


Updated: 2020-08-06 by

Last Updated June 25, 2015

The U.S. Supreme Court has upheld health care subsidies for residents of all states, including those that rely on Healthcare.gov, the federal government’s health insurance exchange. As described below, King v. Burwell could have ended tax-credit subsidies for states that use the federal marketplace to facilitate the purchase of health insurance plans under Obamacare.

Even though Hawaii operates its own health insurance exchange, the King v. Burwell decision is good news for consumers in the state. The 6-3 ruling means that almost 6.5 million Americans will continue to receive the financial assistance that lets them afford health insurance. This helps to keep insurance costs and coverage steady for everyone, avoiding the "death spiral" that might have undermined Healthcare.gov and destabilized the Affordable Care Act as a whole.

The following panel discussion from Kaiser Health News offers a comprehensive discussion of the Supreme Court decision:

You can read the full court decision here.


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How Hawaii Residents May Be Affected by the Supreme Court Obamacare Case: King v. Burwell

On March 4, 2015, the U.S. Supreme Court is set to hear arguments in King v. Burwell, a case that could decide the future of the Affordable Care Act. The central question before the court is whether residents of states that use the federal health insurance marketplace (HealthCare.gov) are eligible for subsidies to purchase health insurance -- or whether financial assistance can go only to people in states that run their own health insurance exchanges. Opponents are fighting over the actual wording of the law, arguing about whether or not it allows the federal government to offer subsidies through its own exchange. The Supreme Court's decision on the matter is expected in June.

King v. Burwell puts at risk the tax-credit subsidies for more than 13 million people -- that’s the number of Americans expected to obtain financial assistance through HealthCare.gov in 2016.

The following map from the Kaiser Family Foundation shows the states in which residents could lose federal subsidies for health insurance. Subsidies are safe only in the gray states. (For an interactive version of this map and the estimated number of subsidized enrollees in Hawaii, see the Kaiser Family Foundation website.)

King v. Burwell Subsidy Map

Obamacare subsidies in Hawaii are not at direct risk from the King v. Burwell decision. But that doesn’t mean all will be well if the Supreme Court strikes down subsidies in other states. The loss of subsidies would likely cause millions of Americans to drop their health care coverage, sending premiums skyward for others and destabilizing the entire structure of the ACA.

In an early poll, almost two thirds of Americans said that if the Supreme Court places limits on subsidies, they would want Congress to immediately act to maintain financial assistance in all states. And majority of residents in states that use HealthCare.gov would want their state to open its own exchange.

So far, neither Congress nor the Obama Administration has come forward with an alternative plan, should the Supreme Court prevent the federal government from offering financial assistance to those who buy insurance through federally operated Obamacare marketplaces.

We will post updates here as they become available.

To learn more about how subsidies currently work in Hawaii, see Ways to Save Money on Obamacare in Hawaii.


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Learn about the 2021 rates for Obamacare in Hawaii.


Hawaii: Law