Another Plan B for ACA If SCOTUS Strikes

Having considered some pretty bad scenarios yesterday for what would happen politically if the Supreme Court strikes down Obamacare subsidies for states that haven’t set up their own insurance purchasing exchanges, there was an interesting straw in the wind about possible developments at the state level, per a report from Sarah Ferris at The Hill:

A number of states are quietly considering merging their healthcare exchanges under ObamaCare amid big questions about their cost and viability.

That mainly has to do with a pending phase-out of federal subsidies for state exchanges–a phase-out that could be delayed or eliminated. But here’s the more interesting wrinkle:

Other states are being driven to consider the idea by the King v. Burwell case, in which the Supreme Court will decide whether subsidies are allowed in states that didn’t set up their own health exchanges.

If the court rules against the Obama administration, millions of people in states across the country will lose subsidies.

Some of those states could be interested in joining with other states that have their own ObamaCare exchanges.

Huh. We’ve heard all along that it wouldn’t be possible for states to create their own exchanges fast enough to restore the subsidies if SCOTUS strikes, absent some very unlikely federal action. But expanding an existing state exchange to cover more states is another matter.

Such a scheme probably couldn’t work for more than a few states that have good relationships with contiguous states that have their own exchanges. And the idea doesn’t deal with the political pressure red states will experiences opposing any “fix” whatsoever for the godless socialistic system. But it’s one positive possibility when few others exist.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.