Back in 2013, when Republicans were itching to show how much they hated Obamacare, the legislature passed Senate Bill 4. The bill is known mainly for stopping the expansion of Medicaid, costing the state millions of dollars in needed funds and denying insurance to about 500,000 people. But it also prevented any “department, agency or institution” from setting up a state-based exchange. Senate Bill 4 was designed as a snub to the Affordable Care Act and to poke a stick in the eye of those freeloaders with the audacity to think they deserved health care if they couldn’t afford it.

In the years since, more than 500,000 North Carolinians have received health insurance under the Affordable Care Act. Almost all receive subsidies. That could soon change.

The Supreme Court could rule as soon as today that the subsidies for people using the federal exchange, everybody in North Carolina, are unconstitutional. The case is being decided about the language of the bill more than the substance, but that won’t matter to people if they lose their subsidies. And they can blame the GOP who have tried to sabotage the legislation since its inception.

Commissioner of Insurance Wayne Goodwin points out that the ruling could have implications beyond just people using Obamacare. The law would still be intact, requiring people to purchase insurance and fining them if they did not. Without the subsidies, many people would be unable to afford it, leaving them uninsured and back in the emergency room for their primary care. It could also cause insurance rates to rise for everybody to pick up the cost.

Back in 2012, Goodwin and his Department were working with the federal government–and the McCrory transition team–to set up a state exchange. Had the legislature let them continue with their work, North Carolina wouldn’t be affected by the court’s impending ruling. Now, we’re waiting to see if our insurance system is thrown into chaos  or not. If it is, you can blame the Republicans.

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