Patient Advocates: Congress Intended for Tax Credits in Federal and State Marketplaces


In a friend-of-the-court brief filed today with the U.S. Supreme Court in the case of King v. Burwell, leading groups fighting chronic disease provide scientific evidence of the grave consequences if millions of people nationwide were to lose the tax credits provided under the Affordable Care Act that provide the financial assistance they need to afford health coverage.


WASHINGTON, D.C. — January 27, 2015 – In a friend-of-the-court brief filed today with the U.S. Supreme Court in the case of King v. Burwell, leading groups fighting chronic disease provide scientific evidence of the grave consequences if millions of people nationwide were to lose the tax credits provided under the Affordable Care Act that provide the financial assistance they need to afford health coverage.

The brief from the American Cancer Society, American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association and National Multiple Sclerosis Society argues that Congress intended for the law to improve access to health care nationwide by making tax credits available to eligible consumers who purchase a health plan in either a federal or state marketplace.

Following is a statement from the organizations:

"Extensive scientific evidence demonstrates that access to quality, affordable health coverage saves lives. Several studies have shown that the uninsured are more likely to die or suffer serious complications from conditions such as cancer, diabetes, heart disease, multiple sclerosis and stroke than are people with health insurance. Being uninsured with a serious chronic disease can also result in more expensive care, a greater risk of personal bankruptcy and higher health care costs system-wide. For example, published data show that:

  • The uninsured are more than four times as likely as those with health coverage to be diagnosed with advanced-stage breast cancer and 1.4 times as likely to be diagnosed with advanced-stage cervical cancer. Uninsured patients with stage IV colorectal cancer are nearly four times as likely as patients with private insurance to go without cancer treatment altogether.
  • Uninsured patients with cardiovascular disease experience higher mortality rates and poorer blood pressure control than the insured.
  • Uninsured people who suffer an ischemic stroke have greater neurological impairments, longer hospital stays and up to a 56 percent higher risk of death than the insured.
  • Patients with no health insurance are twice as likely to have a diabetic complication as patients with health insurance.
  • Access to health insurance can determine whether a patient with MS gets a prompt diagnosis and receives early and ongoing treatment, which is essential to reducing the frequency and severity of relapses and slowing the progression of the disease.

“If the Court voided premium tax credits in the federal marketplace, an estimated 9.6 million people in 34 states would no longer be able to afford health coverage, leaving most of them no choice but to become uninsured. The deliberations that led to passage of the Affordable Care Act made it clear that Congress intended for consumers in both federal and state exchanges who meet income eligibility requirements to receive financial assistance that would enable them to afford health insurance.

“There is no evidence suggesting that lawmakers believed eligibility for tax credits should hinge on whether the state where a person lives chooses to establish its own exchange or have the federal government operate an exchange. Our organizations would have strenuously objected to any suggestion that the physical and financial health of patients with serious diseases should depend on the entity administering the exchange in their state. We would have objected even more strongly to any legislative provision that used patients’ well-being as a bargaining chip to induce states to establish their own exchanges.

“With the Affordable Care Act, Congress responded to gaping holes in the health insurance system that left millions of people — particularly those affected by serious chronic conditions – unable to afford health coverage, likely to face overwhelming health care costs and dangerously susceptible to illness and disability. The law cannot accomplish Congress’ intent to significantly improve access to quality, affordable health coverage unless federal financial assistance is available to eligible Americans in federal and state marketplaces nationwide.”

“On behalf of the millions of people in America with serious chronic diseases, we urge the Supreme Court to rule that people who meet income eligibility requirements can receive tax credits to make coverage more affordable in both federal and state marketplaces.”

View the full amicus brief here.


The American Cancer Society combines an unyielding passion with nearly a century of experience to save lives and end suffering from cancer. As a global grassroots force of more than three million volunteers, we fight for every birthday threatened by every cancer in every community. We save lives by helping people stay well by preventing cancer or detecting it early; by helping people get well by being there for them during and after a cancer diagnosis; by finding cures through investment in groundbreaking discovery; and by fighting back by rallying lawmakers to pass laws to defeat cancer and by rallying communities worldwide to join the fight. To learn more about us or to get help, call us anytime, day or night, at 1-800-227-2345 or visit

ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit

The American Diabetes Association is leading the fight to Stop Diabetes


and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit Information from both these sources is available in English and Spanish.

The American Heart Association is devoted to saving people from heart disease and stroke — America’s No. 1 and No. 4 killers. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit or call any of our offices around the country. Follow us on Facebook and Twitter.

The National Multiple Sclerosis Society mobilizes people and resources to drive research for a cure and to address the challenges of everyone affected by MS. In 2014, the Society invested $50.6 million to advance more than 380 research projects around the world in order to stop MS in its tracks, restore what has been lost and end MS forever. Through its comprehensive nation-wide network of programs and services, it also helped more than one million people affected by MS connect to the people, information and resources needed to live their best lives.

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