The Implications of a Supreme Court Finding for the Plaintiff in King vs. Burwell

Supreme Court - Washington, DC.

Researchers examine the impact that the Supreme Court’s ruling on King v. Burwell could have on the number of people uninsured and on insurance premiums in states with federally facilitated marketplaces.

The Issue

At stake is whether or not modest-income Americans enrolled in the federal health insurance marketplaces are eligible to receive premium tax credits and cost-sharing reductions, as they do under the current implementation of the Affordable Care Act.

Key Findings

  • The number of uninsured Americans would jump by 8.2 million in 2016 if the Court rules that premium tax credits cannot be extended to people living in the 34 states with federally facilitated marketplaces (FFMs).

  • On average, the annual premium for nongroup insurance coverage in FFM states would go up 35 percent or $1,460 per person, if the court rules in favor of eliminating premium tax credits and cost-sharing reductions to people living there.


The authors find that the number of uninsured Americans would increase because, without premium tax credits, purchasing coverage through the marketplaces would become unaffordable to many.

About the Grantee

The Urban Institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic and governance problems facing the nation. For more information, visit Follow the Urban Institute on Twitter or Facebook More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at