Foundation Applauds Court Decision to Uphold Federal Health Insurance Subsidies

SAN FRANCISCO, June 25, 2015—In a 6-3 ruling issued today, the United States Supreme Court upheld the ability of citizens of 34 states to continue to access insurance through the federal marketplace and to access federal subsidies to support their insurance premiums, regardless of whether the state of residence has its own insurance marketplace.  

“We applaud the Supreme Court's decision to uphold the original congressional intent to expand, not curtail, access to health care insurance for uninsured Americans regardless of where they live,” said Neil Giuliano, San Francisco AIDS Foundation CEO. “For thousands of individuals living with HIV, in states that have not expanded Medicaid or implemented the Affordable Care Act (ACA) by establishing their own benefits exchanges, especially in the Deep South, this decision guarantees their unfettered access to preventive health services, medical care and HIV treatment.”

California developed its own insurance marketplace, Covered California, in 2012 and expanded its California Medical Assistance Program (Medi-Cal) coverage to include individuals at 138% of the federal poverty level (an annual household income of $32,913 for a family of four), regardless of pre-existing conditions. Governor Jerry Brown has gone further to ensure health care access to immigrant families and children, regardless of status, living in California who are not currently covered by the ACA.

While today’s ruling marks significant progress toward ensuring access to health care for all, HIV/AIDS advocates continue to work toward leveling the cost of antiretroviral drugs: Some health insurance companies place antiretroviral drugs on the top tiers of drug formularies—driving up the out-of-pocket costs for patients—and use pre-authorizations and other tactics used to deter individuals at risk for HIV from using pre-exposure prophylaxis (PrEP) as a method to prevent HIV infection.

San Francisco AIDS Foundation remains committed to fighting all efforts to restrict access to care and treatment while fighting to keep access available and affordable.

About San Francisco AIDS Foundation
No city experienced epidemic levels of HIV faster than San Francisco. At San Francisco AIDS Foundation, we work to end the epidemic where it first took hold, and eventually everywhere. Established in 1982, our mission is the radical reduction of new infections in San Francisco. Through education, advocacy, and direct services for prevention and care, we are confronting HIV in communities most vulnerable to the disease. More information about the foundation is available at

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