GOP-led states weigh options should Supreme Court rule against ACA subsidies

More states willing to build their own exchanges so residents can receive subsidies

Several states with a history of opposition to state insurance exchanges are now weighing their options should the Supreme Court rule in favor of the plaintiffs in the upcoming King v. Burwell case. 

South Carolina, for instance, which supported the plaintiffs' argument, may consider setting up a marketplace, Gov. Nikki Haley (R) told the Washington Post.

In Pennsylvania, meanwhile, payers and providers hope to convince a GOP-led legislature that the result would be devastating if the Supreme Court rules against the tax subsidies. In that sense, establishing a state marketplace takes on even greater importance in order to preserve subsidies, reported the Post.

Maine, South Dakota and Utah are among other GOP-led states that now look into setting up their own exchanges. While this is indeed a viable option, it may prove challenging. On the surface, an exchange appears to be just a website, but it's far more complex, as setting up an exchange requires a huge investment of both time and resources.

As states look ahead, some conservative industry experts believe a ruling against subsidies will not be the end of the world. The consequences are so grave that states will face "hydraulic pressure" to act and set up their own marketplaces, Thomas Miller of the American Enterprise Institute told the Post.

With two days until the Supreme Court hears the oral arguments, many Republicans in Congress have been working to craft a new healthcare plan in case the plaintiffs win.

Senators Lamar Alexander (Tenn.), Orrin Hatch (Utah) and John Barrasso (Wyo.) unveiled a plan in a Post opinion piece that "creates a bridge away from Obamacare." Their plan includes financial assistance to help Americans keep coverage, as well as more freedom and flexibility for states to create greater competitive markets with more options.

The Supreme Court will hear King v. Burwell Wednesday, March 4, with a decision likely by June.

For more:
- here's the Post story and opinion piece

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