Justices' ruling seen as rallying cry for Medicaid expansion

Public health advocates and providers who serve large populations of low-income patients say Thursday's U.S. Supreme Court ruling was vital toward ensuring healthcare access to the most vulnerable patients.

The court ruled 6-3 to uphold an earlier ruling that made tax credits available to individuals who purchased health insurance through the federal exchange.

The loss of subsidies for an estimated 6.4 million Americans would have added economic burdens for many of the country's public hospitals, which are facing the threat of declining revenues as a result of pending cuts to the Medicaid disproportionate-share payments program. 

Those payments have been used to offset the costs incurred in providing uncompensated care. The bulk of payments have traditionally gone to safety net hospitals serving large low-income populations.

Both Medicare and Medicaid DSH payments covered $21 billion of the $44 billion in uncompensated-care costs hospitals amassed in 2013, according to a May 2014 study published in Health Affairs.