If the U.S. Supreme Court rules against the Affordable Care Act later this month in the King v. Burwell case, there still may be hope for insurers to keep their members who need subsidies to afford coverage. That's because it might be easier than initially thought for states to create their own health insurance exchanges and save consumers' subsidies, reported The Hill.
Pennsylvania and Delaware recently proposed an alternative solution to ensure their residents can continue receiving subsidies. They want to launch their own state-based exchanges by using parts of Healthcare.gov, including its website and call center.
If those plans move forward, the other 36 states using Healthcare.gov could likely consider implementing similar strategies.
"I think that's a pretty easy workaround," Thomas Scully, the former director of the Centers for Medicare & Medicaid Services (CMS) during the George W. Bush administration, told The Hill. "The administration has a lot of flexibility, potentially, to define a state exchange."
Likewise, state officials increasingly are considering buying federal technology to help them maintain their subsidies. Nevada, New Mexico and Oregon already share Department of Health and Human Services (HHS) technology and others might follow suit.
Scully suggested that states could hire CMS as a contractor to help administer their own exchanges. "You can hire whoever the hell you want as a contractor," he said. "You can contract a bunch of people in Philippines to do a call center. Why can't you contract CMS for an exchange?"
But states considering their own exchanges might find that their residents aren't supportive of the idea. A recent poll found that most voters in the 34 states using Healthcare.gov don't want their states launching their own exchanges, FierceHealthPayer previously reported.
What's more, Delaware and Pennsylvania remain in the minority. Many of those states remain largely unprepared to deal with the loss of subsidies, the Los Angeles Times reported. Political pressure from Republicans legislators and governors opposed to the ACA has made contingency planning difficult in many states, according to the article.