The Supreme Court ruled on the landmark Affordable Care Act (ACA) case, King v. Burwell in June 2015. While fears of change might have been quelled by this decision, businesses owners should strive to understand this case and its potential impacts in anticipation of future modifications.

According to recent surveys, employer awareness of the recent Affordable Care Act (ACA) Supreme Court case was minimal, and employer understanding of the final decision was even lower. While the King v Burwell Supreme Court case may be over, businesses owners should be mindful of its implications, and of the inevitability of more ACA amendments and health care reform-related changes to come.


The King vs. Burwell Supreme Court case debated the legality of who is eligible to receive federal subsidies for health insurance in states where exchanges are run by the federal government as opposed to run by the state. Subsidies are available for low to moderate-income people who could not afford to purchase health insurance on their own and whose employer did not offer affordable, minimum essential coverage.

The argument hinged on a phrase used in the law itself – “established by the State” – and whether subsidies were meant to be bought only by people in marketplaces that had been set up by their state. Thirty-four states opted to not set up state health insurance exchanges, instead residents purchase insurance through the federal exchange, Those 34 states were at risk of losing access to these subsidies (aka premium tax credits).


In June 2015, the Supreme Court voted 6-3 to keep the law as is – meaning eligible people can receive federal subsidies to purchase health care insurance, regardless of whether their state government or the federal government runs their health care exchange.


The ruling allows more than 6 million people to continue to receive federal subsidies (Mercer). Had the ruling gone the other way, individuals would have had to support the cost of increased health insurance premiums.


Eligible employees working fewer than 30 hours per week continue to have access to health insurance subsidies. Employers may continue to rely on subsidized health insurance subsidies so their employees can have health insurance.

Employers and the ACA Supreme Court ruling

If the ruling had gone the other way, businesses in states without access to federal subsidies would have been freed from complying with the employer mandate because penalties for non-compliance are only triggered if one employee receives a subsidy for health insurance through an exchange. Without the subsidies, no penalty would be tiggered. Considering the actual outcome, employers, with 50 or more employees, are now subject to ACA penalties, which is triggered when one of its full-time employees receives a subsidy.


As shown above, not everyone stays up to date on health care reform news. Since 2010, employers have had to accommodate changes and delays in the law, learn complex regulatory guidelines, and be challenged to meet those requirements in order to stay compliant. While the ruling does not dictate that employers offer benefits directly to their employees or through the exchange, employers should take this as a cue to evaluate their benefits offerings and health care strategies.

While this may not have changed anything now, there are still reporting requirements that employers must comply with. Failing to do so will result in fines and penalties for employers of every state.