SEATTLE — In the wake of the U.S. Supreme Court’s recent ruling to uphold the Affordable Care Act (ACA), Attorney General Bob Ferguson offered the following statement, and a fact sheet detailing the ACA’s impact on Washington state. Washington state was part of the coalition defending the ACA, because the Trump Administration refused.

“It’s hard to overstate the importance of this victory,” Ferguson said. “This is a victory for the 825,000 Washingtonians who receive coverage through the ACA. In some Washington counties — Yakima, Adams, Okanogan — more than 43% of individuals under 65 rely on ACA programs for health care. Thanks to this hard-won and important legal victory, these Washingtonians get to keep their health care.”

ACA fact sheet
The ACA provides health coverage to more than 800,000 people in Washington state and tens of millions of people nationwide.

Nearly 200,000 Washingtonians get subsidies under the ACA to help them buy health care policies.

According to the Health Benefits Exchange, in 27 of the state’s 39 counties, at least 30 percent of those under 65 get health care from ACA-related programs. In five counties, it’s more than 40 percent (Adams, Okanogan, Pacific, Pend Oreille and Yakima).

Impacts to coverage:
Between 2010 and 2015, an estimated 537,000 people in Washington gained coverage thanks to the ACA, including those who gained coverage through the Washington Health Insurance Marketplace, about 50,000 young adults who gained coverage by staying on their parents’ health insurance, and those gaining coverage from the law’s Medicaid expansion and employer shared responsibility policy.

In 2017, 63 percent of Marketplace enrollees in Washington received a premium tax credit that averaged $3,040 per person.

Impacts to Washingtonians with pre-existing conditions:
Up to 2,969,739 people in Washington have a pre-existing condition and would be at risk for being charged unaffordable premiums or denied coverage altogether without the ACA.

Impact on Medicaid:
Without the ACA, an estimated 55,000 fewer people in Washington would have Medicaid coverage.

Impact on Medicare:
Without the ACA, the 1,238,649 people with Medicare in Washington would lose benefits and pay more.

Prescription drug discounts through the ACA provided 71,499 people in Washington with $1,065 in average annual savings per beneficiary in 2016.

In 2016, 805,142 Washingtonians with Medicare had coverage for proven preventive services with no cost sharing.

Impact on public health:
Washington received $84,038,862 from the law’s Prevention and Public Health Fund between fiscal years 2012 and 2016. This includes $21,648,368 for immunizations and $4,207,707 for tobacco cessation efforts.

An estimated 3,079,369 people in Washington, including 1,258,201 women ages 15 to 64, would lose federally guaranteed preventive services — like flu shots, cancer screenings and contraception — which are now provided at no extra cost to consumers.

Impact on health care costs:
Without the ACA, between 2019 and 2028, Washington would lose $4.7 billion in federal Marketplace spending and $38.1 billion in federal Medicaid spending — a total of $42.8 billion.

From 2019 to 2028, Washington hospitals would lose $23.3 billion and physicians could lose $7.7 billion.

Uncompensated care costs in Washington would increase by $33.9 billion in the same timeframe.

Case timeline:
February 2018 — Texas and 19 other states file challenge to invalidate the law after Congress “zeroes out” the penalty associated with the ACA’s individual mandate

April 2018 — Washington and 16 other states seek to intervene in the case

June 2018 — Trump Administration tells the court it will not defend the ACA

December 2018 — District Court Judge Reed O’Connor rules that the entire ACA is invalid without the individual mandate penalty

December 2019 — Three-judge panel of the Fifth Circuit issues a 2-1 ruling, agreeing with Judge O’Connor that the individual mandate is unconstitutional, but remanding back to him to consider whether parts of the ACA are severable

January 2020 — States petition for certiorari and ask for the case to be heard on an expedited basis, arguing that the individual mandate question is central to the entire case, and can be answered by the Supreme Court now

March 2020 — Supreme Court agrees to hear the case, but not on an expedited basis

Nov. 10, 2020 — Oral arguments heard before the Supreme Court

June 17, 2021 — Supreme Court rules against the states challenging the ACA