Terry Donald, a self-employed junk hauler who lives in St. Petersburg, Florida, didn’t fully appreciate the value of his health insurance until last spring. That’s when he sliced his arm open on a broken mirror and had to rush to the ER for stitches. Then on Labor Day, he tripped in the yard and cut his leg. At first it didn’t seem bad, but after about 10 days, the wound began to look infected. He had to get surgery for what turned out to be a severe staph infection. After a long hospital stay, he couldn’t work for a month. Meanwhile, his wife kept filling her regular prescriptions for a thyroid condition. When Anthem, his insurer, sent him an estimate of how much it had paid out for the couple’s care over those few months, the total was more than $90,000, he says. Donald, meanwhile, only faced co-pays that were tiny by comparison. “At that point, I noticed how easy everything was,” he told me recently. Donald and his wife are able to afford their generous health plan, for which they pay about $200 per month, because they get a tax credit through Obamacare that adds up to savings of about $5,000 per year. Before Obamacare, he remembers signing up for catastrophic plans that had deductibles over $10,000. “Just having that tax credit up front is a little ease of mind,” he said. “You don’t have to worry every month when the bill comes in.” Today, the Supreme Court will hear arguments in King v. Burwell, a case that threatens to yank the tax credit away from Donald and millions of other people like him. Under the Affordable Care Act, otherwise known as Obamacare, the states were invited to create exchanges, or online marketplaces, where uninsured individuals must buy insurance plans. In the states that opted not to create one—either for logistical reasons or out of political opposition to the law—consumers were told to use an exchange created by the federal government through Healthcare.gov. Florida is one of these states.

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