Affordable Care Act Threatened: Here’s How You Can Help Save It

Feb 4, 2015

Many social workers may be unaware that on November 14 the U.S. Supreme Court announced that it would take up the case King v. Burwell, which challenges the legitimacy of the Affordable Care Act (ACA).

In previous challenges to ACA, the opposition questioned the constitutionality of the individual mandate required in the law. However, this more recent case does not make such claims about liberty or the reach of federal power.

King v. Burwell centers on a section of the ACA that deal with subsidies, tax credts that help low- and moderate-income residents afford monthly health insurance premiums. If the plaintiffs win this case win, the federal government will end ACA tax credits for residents in all of the states with federally facilitated marketplaces. As a result, millions of residents would not be able to pay for their health insurance.

Working Poor Would Be Most Hurt by Negative Court Ruling

Not only is it disappointing that the Supreme Court decided to take the case, but the consequences of an adverse ruling could be devastating to America’s working poor. The Urban Institute completed an analysis of how an adverse ruling in the King v. Burwell case will impact specific segments of those covered by ACA. According to the Uran Institute:

  • Three million people may lose ACA tax credits if the Supreme Court rules in favor of the plaintiffs;
  • Between 6.2 and 8 million adults and children would become uninsured;
  • Most of those who will lose heath insurance are adults with incomes between 138 percent ($16,104 per year) and 400 percent ($46,650) of the federal poverty level;
  • More than 60 percent of those who would become uninsured are white, non-Hispanic and over 60 percent would reside in the South;
  • More than half of adults have a high school education or less; and
  • 80 percent will be employed.

King v. Burwell deserves the attention and advocacy of the social work community. For example, we should not assume that the Supreme Court is impervious to public pressure, especially when deciding on cases that can have a life altering effect on millions of vulnerable people.

We should also be wary of those who suggest that even if the Court rules in favor of the plaintiffs, Congress will simply amend the subsidy language in ACA to reflect their original intent. Given the make-up of 114th Congress, it is more likely that they will use an adverse decision as a way to gut the law..

It is good news that it is now expected that as many as 30 states will agree to participate in ACA by expanding Medicaid eligibility to low income single adults. It would be appalling to lose such a safety net resource just when it is proving to be increasingly effective.

What Can Social Workers Do?

Many Americans think the Supreme Court is not susceptible to public pressure in their deliberations. This is not necessarily true. There have been a number of occasions in modern history where the Court clearly incorporated public sentiment in their decision.

There are several ways you can voice our concerns to the Supreme Court. One way is to submit editorials and post on the social media to express deep concerns about the millions of individuals and children who will become uninsured after having been covered by an otherwise very successful safety-net program.

We can also join national coalitions that are planning a number of advocacy actions, including rallies in front of the Supreme Court on the day of King v. Burwell oral arguments. These arguments are scheduled for March 4.

The National Association of Social Workers is already part of a coalition that is led by the Center for American Progress and Doctors for America  in attempt to influence the outcome of this case.

Many Americans think the Supreme Court is not susceptible to public pressure in their deliberations. This is not necessarily true.

NASW and the coalition will hold a rally in front of the Supreme Court on the day of the case’s oral argument . NASW is hoping a significant number of social workers will attend this important event.

Courts Do Matter

Aside from its threat to ACA, this case should reinforce the fact that social workers need to recognize that courts matter. Those of us who will join rallies and write to our Congressperson person should keep in mind that there will be many other court challenges to significant safety-net laws and policies.

These cases are first heard in the lower federal courts before they get to the Supreme Court. Therefore, it is important that we pay attention to and lend our voices to the judicial philosophies of each person who is nominated to fill vacancies in the 11 Federal Courts of Appeals as well as the lower federal courts.

For more information about March 4, ACA rally at the Supreme Court, contact Mel Wilson, NASW Social Justice and Human Rights manager, at