Analysis: King v. Burwell

People With Disabilities Still Face Challenges

Continuing problems for the using Healthcare Exchanges

BELLEVILLE, IL–(Marketwired – Jun 26, 2015) – The U.S. Supreme Court decision upholding federal subsidies as part of the Patient Protection and Affordable Care Act of 2010 (ACA) affirms important measures that allow low- and middle-income people with disabilities in 34 states to afford critical health insurance coverage.

But challenges remain for individuals with severe disabilities who continue to struggle with accessing healthcare, according to Allsup, a nationwide provider of Social Security Disability Insurance (SSDI) representation, veterans disability appeal and Medicare plan selection services.

Access and cost hurdles remian

"Hundreds of thousands of people with disabilities continue to face access and cost hurdles in getting healthcare in those states where Medicaid was not expanded," said Tricia Blazier, personal health and financial planning director for Allsup.  "In addition, individuals receiving disability insurance benefits must grapple with confusing income stipulations and the complexity of joining the Marketplace outside of the traditional open enrollment period."

The Supreme Court's ruling in King v. Burwell ensures individuals with severe disabilities who can no longer work and lose employer-provided healthcare coverage, and whose SSDI benefits are pending, have a means for receiving critical medical treatment through the exchanges, Blazier said.

Residents in 34 states with federally facilitated Marketplaces were directly impacted by the ruling, which examined language in the healthcare law stating the exchanges were "established by the state." The remaining states and District of Columbia had state-based Marketplaces.

Obstacles Remain For SSDI Beneficiaries

In many ways, the ACA has advanced healthcare access for people with disabilities in the five years since enacted. One example is the provision that insurers can no longer deny coverage to individuals with pre-existing conditions.

However, nearly 1 million people who receive Social Security disability benefits each year must navigate a Health Insurance Marketplace that is complicated by state differences in Medicaid and the lack of a special enrollment period for SSDI receipt.

"The Health Insurance Marketplace provides a needed alternative for ongoing medical treatment for the hundreds of thousands of people who will receive SSDI benefits this year, especially because they must wait 24 months to become eligible for Medicare," Blazier said. "Unfortunately, too many of these individuals go without healthcare because they cannot easily access the exchange due to timing, income changes and other complexities of the program," she said.

No special enrollment period

Hundreds of thousands of people with disabilities continue to face access and cost hurdles in getting healthcare in those states where Medicaid was not expanded

Experiencing a severe disability and receiving SSDI benefits creates a change in income and life circumstances for beneficiaries. However, there is no special enrollment period in the Marketplace for these individuals. Establishing SSDI benefits as a special enrollment period and modifying and related materials would help address this significant hardship for individuals with severe disabilities. Obstacles also remain for those individuals living in states that did not expand Medicaid following the ACA.

"Unfortunately, large numbers of people with severe disabilities who could benefit most from health insurance through the Marketplace are unable to get it," Blazier said. "Steps must be taken to ease the burden for these individuals who have already lost so much due to a severe disability that has drastically impacted their lives."

Social Security Disability Help
Click here for more information about applying for Social Security disability benefits, or contact Allsup's Disability Evaluation Center at (800) 678-3276.
Find more information about choosing Medicare plans at, learn about the Allsup Medicare Advisor®, or call (866) 521-7655.




Allsup is a nationwide provider of Social Security disability, veterans disability appeal, exchange plan and Medicare services for individuals, employers and insurance carriers. Allsup professionals deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. Founded in 1984, the company is based in Belleville, Illinois, near St. Louis. For more information, go to or visit Allsup on Facebook at The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.
Allsup provides free healthcare assistance with the Health Insurance Marketplace to its SSDI customers to help them maintain access to necessary medical treatment. The Allsup Medicare Advisor® also assists individuals with choosing their Medicare coverage once they become eligible, typically 24 months after cash SSDI benefits begin.