NEW YORK (TheStreet) -- HCA Holdings Inc. (HCA), which runs 155 U.S. hospitals, has argued vehemently against taking subsidies away from customers who buy insurance on federally operated exchanges but says it's well positioned even if the U.S. Supreme Court does just that.
Over the long run, rivals such as Tenet Healthcare (THC), and Community Health Systems (CYH) are unlikely to be significantly hurt either, said Morningstar analyst Vishnu Lekraj. Still, "there could be some near-term growth headwinds for some of these companies if the Supreme Court rules that subsidies are unconstitutional," he cautioned.
The crux of the Supreme Court case, King v. Burwell, is federal subsidies in 34 states that have federally operated exchanges, as opposed to state-run platforms. The petitioners in the case, including David King, argue that the Internal Revenue Service isn't allowed to extend the subsidies provided by the Affordable Care Act to those states because the law allows them only for exchanges run by a state. Without the subsidy, the 64-year-old King, a Virginia resident, would have been exempt from the law's requirement that he get insurance because his income was too low.
The government argued that King's interpretation is contrary to the spirit of the law, which was intended to provide more affordable health care coverage for all Americans. To function successfully, its three pillars -- the individual coverage mandate, a requirement that insurance companies provide coverage regardless of health history, and subsidies for those who can't afford insurance -- must be retained, according to a brief submitted on behalf of the U.S. Department of Health and Human Services and Secretary Sylvia Burwell.
HCA took a similar position in a separate brief submitted to the justices.
"The consequences of petitioners' interpretation are so absurd that the Congress could not possibly have intended them," the Nashville, Tenn.-based company argued. HCA has a significant stake in the decision, since 88% of its facilities are located in a state with a federally run exchange.
While uninsured patients typically pay nothing to HCA for the care they receive, those with insurance from the exchanges pay an average of $390 out-of-pocket per visit and are three times less likely to seek emergency-room care, which is more expensive than outpatient visits, the company said.