If King v. Burwell is decided in favor of the plaintiff, additional coverage resulting from the ACA’s premium tax credits would be reversed, and some of those purchasing nongroup insurance fully with their own funds would become uninsured due to large increases in premiums. Consequently, spending on medical care would decline in the affected states. This analysis estimates the effect of such a change on hospital, physician, prescription drug and all other spending, noting how much of the continued spending would be self-paid by the uninsured and how much would rely upon historic rates of uncompensated care funding persisting.

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