“As the Supreme Court prepares to hear oral arguments in King v. Burwell tomorrow, states are watching the Court very carefully. Sixteen states and the District of Columbia have established state-based exchanges. King’s challenge to whether the Affordable Care Act’s premium subsidies can be made available in states with exchanges run by the federal government could have significant implications, as many as eight million Americans may be affected by the outcome. Insurance markets could see significant premium increases and health care providers could lose billions. Given the high stakes, states must prepare and plan to take action to avoid disruptions in coverage if the Supreme Court decides in King’s favor.
Several states are already considering plans for future exchange coverage options that may help them prepare depending on the outcome of the case. As of today, at least 10 states have new legislative proposals pending to transition the state from a federally-facilitated exchange to a state or partner-based model. At least 10 states have proposed bills that either eliminate an existing state-based exchange or prohibit the establishment of a state-based exchange. In New Hampshire, where the exchange is managed in partnership by the federal government and the state, a bill has been introduced to designate the federal exchange be considered the state-based exchange. It would retain state authority over certain functions such as plan certification, plan quality rating, and Navigator program operation.
NASHP, along with the states, will continue to follow this case closely. You wouldn’t go out on a cloudy day without your umbrella, and states cannot wait until June to find out they are without alternative coverage plans for their citizens. While we don’t know what the Court’s decision will be, it’s clear states will continue to consider their options.”
The National Academy for State Health Policy (NASHP) is an independent academy of state health policymakers who are dedicated to helping states achieve excellence in health policy and practice. A non-profit and non-partisan organization, NASHP provides a forum for constructive work across branches and agencies of state government on critical health policy issues.
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