Dive Brief:
- Pennsylvania's health department has submitted an application to create its own healthcare exchange, in the event that the Supreme Court sides with the plaintiffs in King v. Burwell.
- It is one of 34 states that did not establish its own exchange, leaving its residents reliant upon the federal exchange—and therefore vulnerable to losing their insurance subsidies if the plaintiffs in the case prevail.
- By creating its own exchange, Pennsylvania would be able to preserve the subsidies of almost 350,000 people.
Dive Insight:
While a state-based exchange seems a simple enough solution, it is likely to pose a challenge due to opposition from Republican state legislators and time limitations; there will only be four months between the Supreme Court's ruling expected in late June and the beginning of open enrollment in November.
The same issues would apply in the rest of the 34 states without state-based exchanges, as well. Contingency planning has overall been minimal, however, as legislators await the Supreme Court's decision and the Obama administration's reaction to determine whether it's necessary to publicly make any controversial plans.
A Health Affairs blog this week looks at a representative sample of those states (Florida, Michigan, New Hampshire, North Carolina, and Utah) and finds that none of them have specific plans, though it's possible their legislators will be open to establishing exchanges in order to avoid blame from those losing their subsidies.
It is also likely that these states will be counting on getting some form of extensions while building their exchanges, possibly through the entire year of 2016.