The Patient Protection and Affordable Care Act has been one of the great generators of speculation in modern times. The latest speculative outpouring centers on the legal challenge to the tax credit individuals and families have received to make coverage more affordable.

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Weighing in this week: The Robert Wood Johnson Foundation. An earlier RAND study suggested 9.6 million now insured would lose coverage if the tax credit for those with federal exchange insurance were eliminated by the U.S. Supreme Court. The foundation dug deeper into those expected to lose coverage if King v. Burwell goes against the Obama administration.

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"If the Court rules in favor of King, the number of uninsured, nonelderly people would increase by 8.2 million," RWJ projected. "Of the 6.3 million people estimated to lose coverage because they no longer have tax credits to help pay the premium, the researchers estimate:

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  • 61 percent are white, non-Hispanic;
  • 62 percent live in the South;
  • 81 percent work full- or part-time;
  • 82 percent have modest incomes, but are not poor.

The negative effect of such a ruling would have a one-two punch impact, researchers have predicted. Those whose subsidies were eliminated would drop insurance altogether. The impact of that would be to decrease substantially the number of people in the exchange insurance pools, thus increasing premiums for many with insurance. A certain percentage of those would then drop coverage.

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