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King v. Burwell


Lambda Legal filed a friend-of-the-court brief on behalf of nine national HIV advocacy organizations in King v. Burwell, the latest challenge to the Patient Protection and Affordable Care Act (ACA). The brief focuses on the disparate impact that an adverse decision will have on people of color living with HIV in the states that have elected not to run their own health insurance exchange.

“Today, the people most affected by HIV are low-income, rural, southern, Black, and before the Affordable Care Act, mostly uninsured. With this case, the opponents of the ACA seek to make the thousands of people in that community or otherwise living on the margins—who are already struggling to access healthcare—even more vulnerable to the ravages of HIV simply because they happen to live in one of the 34 states choosing not to set up their own health insurance exchange,” said Scott Schoettes, HIV Project Director for Lambda Legal. “When Congress enacted the ACA in 2010, only 17% of people living with HIV had private health insurance---a disheartening statistic given the greatly improved health outcomes and dramatically reduced likelihood of transmission when people have access to consistent care. Today, the key to halting the HIV/AIDS epidemic is access to affordable, reliable and comprehensive care, and the need is especially critical for vulnerable communities of color. We need the Court to recognize the importance of a robust healthcare system for all and to allow the continued implementation of the Affordable Care Act envisioned and intended by the U.S. Congress.”

The Affordable Care Act, signed by President Obama In March, 2010, reformed aspects of the healthcare and insurance system and expanded access to private health insurance for millions of Americans. In King v. Burwell, opponents of the ACA—which is providing access to healthcare for millions of previously-uninsured Americans—would cut subsidies that make health insurance affordable for most low-income residents in the 34 states that have a federally-facilitated health insurance exchange, including tens of thousands of people living with HIV. People earning between 100%-400% of the Federal Poverty Level (23,850-95,400 for a family of four) will lose access to the subsidies that allow them to afford health insurance and maintain their health. The IRS ruled that the subsidies are available to everybody, but the challengers want to limit the subsidies to only residents of states that have set up and are administering their own health insurance exchanges.


  • January 29, 2015 Brief filed, along with the following organizations: Asian and Pacific-Islander Coalition on HIV/AIDS (APICHA), Black AIDS Institute, Gay and Lesbian Advocates & Defenders (GLAD), GLMA: Health Professionals Advancing LGBT Equality (GLMA), HIV Prevention Justice Alliance (HIV PJA), Latino Commission on AIDS, National AIDS Education and Services for Minorities (NAESM), National Black Justice Coalition (NBJC), and National Minority AIDS Council (NMAC).
  • March 4, 2015 Oral arguments held before the Court. A ruling is expected by late June, 2015.
  • June 26, 2015 Victory! In a 6-3 decision, the United States Supreme Court rejected the latest challenge to the Patient Protection and Affordable Care Act (ACA), declaring that health insurance subsidies are available to residents of all states.

Case Information

Status: Closed
Outcome: Victory

Lambda Legal
Gregory Nevins, Senior Staff Attorney
Scott Schoettes, HIV Project National Director

Ropes & Gray LLP
Kristen Mayer
Nicole Cate
Douglas Hallward-Driemeier
Nicholas Perros