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Bills in 12 states would create insurance exchanges

Lawmakers want residents covered if Supreme Court rules federal subsidies illegal

As states continue to weigh their options should the Supreme Court strike down federal subsidies for health insurance in King v. Burwell, lawmakers in 12 states have proposed bills to create an insurance exchange.

Democratic legislators in Ohio plan to introduce a bill this week that would allow the state to create an exchange, the Telegraph-Forum reported. Doing so would allow residents to qualify for subsidized insurance in the event that the Court rules that subsidies are illegal on Healthcare.gov under the Affordable Care Act.

Gov. John Kasich (R-Ohio) has stated that he wants to wait until the King v. Burwell ruling, which is expected in June, before making a decision. But legislators said they want to take a "proactive response," according to the article.

"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). About 197,000 Ohioans received subsidized coverage through Healthcare.gov this year; credits averaged $247 per month.

The effort to create an exchange in Wisconsin, meanwhile, would affect 183,000 residents with average subsidies of $319 per month, according to the Wisconsin State Journal. Democratic legislators said their proposal to create a state exchange continues the work of former Gov. Jim Doyle (D). Current Gov. Scott Walker (R) opted instead to use Healthcare.gov.

"Let's make sure the people of our state are not devastated by partisan politics," said bill co-sponsor Rep. Melissa Sargent (D-Madison), according to the Journal.

Meanwhile, lawmakers in 10 other states have introduced legislation to move from the federal marketplace to state exchanges, according to a report from the National Conference of State Legislatures. The list includes Florida and Texas, the two largest states using Healthcare.gov. Legislation is pending in 11 of the 12 states; a bill to create a state exchange in Virginia did not pass.

Legislative hurdles aside, setting up a state-run health insurance exchange requires significant resources, FierceHealthPayer previously reported. For example, the Badger Health Benefit Authority, which would run Wisconsin's proposed exchange, would require up to 100 employees, the Journal reported.

If the Supreme Court strikes down federal subsidies, the ruling would take effect quickly, Kaiser Family Foundation President Drew Altman wrote in the Wall Street Journal. Qualified individuals could lose their subsidies in as little as 25 days.

To act in the best interest of the 7.5 million Americans who would lose subsidies for health insurance, Altman suggested that either the Supreme Court or the U.S. Congress establish a grace period through the end of 2016 to give states enough time to set up exchanges.

For more:
read the Telegraph-Forum article
here's the Wisconsin State Journal article
read the National Conference of State Legislatures report (.pdf)
read Drew Altman's Wall Street Journal article

Related Articles:
King v. Burwell: Impact on states
GOP-led states weigh options should Supreme Court rule against ACA subsidies
Governors weigh options ahead of King v. Burwell
States could forestall King v. Burwell outcome, but it won't be easy