If the U.S. Supreme Court blocks one of the Affordable Care Act's benefits, one national group predicts 198,000 moderate- and middle-income Missourians could lose "critical financial assistance" for their health insurance premiums.
The group Families USA also broke down its predictions for a dozen states, including Missouri, to the congressional district level. The group said 21,000 people in Blaine Luetkemeyer's 3rd Congressional District, and 22,000 people in Vicky Hartzler's 4th District, could lose benefits.
Ron Pollack, Families USA's executive director, said Tuesday that troubles could come if the nine-member U.S. Supreme Court rejects the federal government's current practice of providing subsidies in all 50 states for the premiums some Americans pay for the health insurance they're required to get under the ACA, which often is called "Obamacare."
"To protect the health of all Americans, it is imperative, obviously, that the court uphold the availability of premium tax credit subsidies in every state," he said.
Right now in Missouri, he said, the "average monthly premium for an individual with subsidized insurance is $82 a month, versus $363 a month without a subsidy, according to a report by the U.S. Department of Health and Human Services."
Part of the ACA provided "exchanges" for people searching for health care policies, with the exchanges to be run either by the states or, in states that declined to set up their own exchange, by the federal government.
The law's language included the phrase "enrolled in through an Exchange established by the State," but ACA regulations, as implemented by the IRS, use a more broad definition encompassing both the state exchanges and the federal exchanges.
The plaintiffs have argued that language means only Americans in states with state-run exchanges can benefit from the financial help.
The New York Times explained: "It centers on a small piece of the complex health law, with potentially big consequences.
"At issue is whether the law's language allows the government to help middle-income people buy insurance everywhere in the country - or only in states that have set up their own insurance marketplaces."
The high court heard arguments in the "King versus Burwell" case in March.
"We're expecting a court decision within the next two weeks," Pollack said. "Our presumption is that the decision will come down at the end of this term.
"And the last day of this term of the Supreme Court is Monday, June 29."
Families USA describes itself as "the national organization for health care consumers. It is nonprofit and nonpartisan, and its mission is to secure high-quality, affordable health coverage and care for all Americans."
Pollack told reporters Tuesday: "If you look at the law in its entirety, we believe it's clear that Congress meant that subsidies should be available in all states, and we believe the court will find that, as well.
"But, if the court rules against the subsidies, devastation will strike both health care consumers and the health care system at large. For most people, when the subsidies are withdrawn - if they are withdrawn - it would mean health insurance premiums are unaffordable."
Most people would drop health coverage because they couldn't afford it, he said.
"We thought it would be helpful, in advance of the court decision, to get a sense of what the stakes are and allow people to understand in their communities, how many people are affected," Pollack said of holding the news conference before the court issues its ruling. "The congressional district numbers will be of even greater value after the court rules - if the court rules adversely in terms of the availability of subsidies."
Nationally, experts think such a ruling could result in 8.2 million more people being uninsured in the 34 states that have federal exchanges.
Many Republicans in Congress have opposed Obamacare from the beginning, and haven't offered any specifics about changing it.
"If the court rules in favor of the plaintiffs and withdraws subsidies, then it will clearly be up to Congress to try and fix this as quickly as possible," Pollack said Tuesday. "There are significant numbers of members of Congress who heralded the bringing of this lawsuit and, if the lawsuit winds up withdrawing subsidies from their constituents, it really will be their responsibility to get this fixed."