ACA legal challenges could cause trouble for states on federal exchange

The recent conflicting court cases over the legality of health insurance subsidies under the Affordable care Act has payers worried.

The results of one of the cases, Halbig v. Burwell, is far from decided, yet it may have dire consequences for health insurance CEOs if it goes far as the Supreme Court, Kevin Lucia, a research professor and project director at the Georgetown University Health Policy Institute's Center on Health Insurance Reforms, wrote in a post on the Commonwealth Fund Blog.

If upheld by the Supreme Court, Halbig would have severe consequences for states that use the federal marketplace, wrote Lucia and his colleague, Justin Giovannelli, a research fellow and faculty member at Georgetown University's Health Policy Institute.

It could cause even more delays and confusion about the ACA.

If the subsidies case makes its way to the Supreme Court and is upheld, striking down financial assistance in more than half of the states, millions of low-income Americans might not be able to afford coverage, as Fiercehealthpayer has reported. 

Millions of people in those states would lose their premium tax credits, making coverage unaffordable for many, increasing uninsurance rates, and dramatically disrupting the states' insurance markets, the Commonwealth Fund Blog noted.

Yet, Lucia and Giovannelli say elected officials in states with federally facilitated marketplaces have the power to ensure that their citizens maintain access to subsidized private health coverage. In the coming months, it will be up to leaders in these states to evaluate these options and decide how best to respond to Halbig's potentially seismic effects, they wrote.

The ACA's marketplace models have evolved over time to give states more flexibility over their level of involvement. Over the past two years, states considering establishing their own marketplaces have weighed a number offactors, including avenues for obtaining legal authority to operate, funding availability, desire to maximize state regulatory oversight, federally established deadlines and their technological capabilities, the post noted.

To learn more
Here's the blog post

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