If the Supreme Court rules for the plaintiffs in a case coming before the court Wednesday about the federal insurance subsidy under the Affordable Care Act, millions would be immediately cut off from support to pay for health insurance premiums, an entire health insurance market would be destabilized, and uninsured patients would flood the nation’s health care system, a Georgia State University law expert says.

Arguments in the King v. Burwell case are expected before the court Wednesday (March 4). The plaintiffs are challenging an Internal Revenue Service (IRS) rule implementing the federal subsidy – arguing that the law only allows tax credits under the Affordable Care Act for individuals purchasing insurance on state-run exchanges, not the federal marketplace where millions of Americans have purchased insurance due to their own states not establishing state-run marketplaces – such as Alabama, Georgia, Indiana, Nebraska, Oklahoma, South Carolina and West Virginia, all states which filed amicus briefs in support of the plaintiffs.

The Fourth Circuit Court of Appeals ruled for the government, upholding the federal tax credits.

“A ruling for the plaintiffs in the King v. Burwell case will immediately cut off subsidies for over 9 million people and cause premiums to jump 35 percent in the individual insurance market,” said Erin C. Fuse Brown, assistant professor of law at Georgia State’s College of Law. “This will hurt even those who do not currently receive subsidies, destabilize the insurance market, and saddle providers with more uninsured patients and uncompensated care costs.

“It is difficult to overestimate how far the ripple effect would reach. This is certainly not what Congress intended when it wrote the Affordable Care Act,” she continued.

Fuse Brown is a member of the university’s Center for Law, Health and Society, with research interests in the intersection of the business and regulation of health care delivery systems. Her recent research has focused on policies affecting hospital prices for health care services, and on the structural fragility of the right to health care under the Affordable Care Act.

She received a J.D., magna cum laude from the Georgetown University Law Center and a Master of Public Health degree from the Johns Hopkins Bloomberg School of Public Health. Fuse Brown holds a bachelor’s degree from Dartmouth College.

For more about Fuse Brown and her research, visit http://law.gsu.edu/profile/erin-fuse-brown/.