Kevin Counihan, the director of HealthCare.gov, was
very blunt with an audience of insurers concerned about the potential aftermath of a Supreme Court decision striking down subsidies for people buying insurance on the federal exchanges. How easy would it be, they asked, for states to step in and create exchanges to keep those policies alive? Not very, was the answer.
Kevin Counihan, the director of HealthCare.gov, told an audience at the National Health Insurance Exchange Summit that creating an exchange is a "very, very complex activity" that could not be achieved in just a few months.
"It would not be something that folks could do for this next open enrollment period," he said during a question-and-answer session, referring to the sign-up period that begins in November.
The easiest solution in the event the Supreme Court blows Obamacare to smithereens would be for Congress to pass simple language to clarify that anyone buying insurance anywhere, on any Obamacare exchange, would get the subsidy. But Republicans are never going to do that. So the next solution, since there isn't a quick fix the administration could do, is that states would have to up their own exchanges. That's not just complex, but
economically difficult. Plenty of states who did set up their own exchanges are struggling to keep them running. But it's not just a technical, or a logistical, or an economic problem, though. It's a political one. The states have to want to do it. Since most of these states are mostly led by Republicans, that's not a given.
So we're back to where we started from, with very few good options to make sure that something like 8 million people don't have their insurance taken away from them by the Supreme Court. Right now, the only solution that is readily apparent is that the Supreme Court just not do it.