In the aftermath of the King v. Burwell oral arguments, it's up to Congress, not the states, to fix the mess should the Supreme Court find subsidies to be illegal in states that did not establish their own exchanges, HealthMarkets CEO Ken Fasola told InsuranceNewsNet.
[Related Special Report: King v. Burwell Supreme Court ruling: What you need to know.]
If the Supreme Court strikes down subsidies, insurers could end up leaving the marketplace due to a lack of consumers who can afford unsubsidized coverage, the article said.
Insurers also worry about how the ruling might impact their 2016 rates. As of now, insurers and regulators are discussing the possibility of proposing two sets of rates at an earlier stage of the review process, Joel Ario of the Commonwealth Fund said in a recent blog post.
It's possible there are solutions to mend the issue at hand, but such issues come with political strings attached. For example, Congress could take action to avoid the loss of subsidies, noted InsuranceNewsNet. The Republican-led Congress could create a short-term fix that maintains tax credits to eligible consumers, but it may be difficult to obtain the necessary amount of votes.
Howevers, insurers and state governments want Congress to act. They do not want to solve the problem on their own. That's even the case in Florida and Texas, which enrolled the most consumers this past enrollment period and therefore have the most to lose if subsidies are struck down.
"Politically, I don't think those states want to do anything about fixing the system. So the states will look to Congress to come up with a solution," Fasola told InsuranceNewsNet.
Indiana Gov. Mike Pence (R) said he is waiting to see what the Supreme Court decides, FierceHealthPayer previously reported. A decision on King v. Burwell is expected in June.
Other states are playing out different scenarios in case the high court does rule in favor of the plaintiffs.
Democratic legislators in Ohio planned to introduce a bill this week that would allow the state to create an exchange, FierceHealthPayer previously reported. "If we wait for the Supreme Court's ruling, we're going to find ourselves at a disadvantage," said state Rep. Michael Stinziano (D-Columbus).