The
Wall Street Journal reports that state officials from a number of states met last month to try to figure out how to stave off disaster if the Supreme Court decides to end Obamacare subsidies to their residents. The consensus—there's not a lot of options.
There is little chance most of the states that use HealthCare.gov could set up their own exchanges fast enough to preserve residents’ tax credits, participants said after the meeting. Several also said that while officials talked about ideas such as leasing an exchange from the federal government or a state that has its own, the hurdles could be too high to overcome. […]
Participants said it was extremely unlikely their state governors, legislatures and insurance commissioners would all agree to set up an exchange if the Supreme Court struck down their state subsidies, and that they could do so before the subsidies could vanish.[…]
As a result, a few supporters of the law are eyeing fresh workaround options, that even they aren’t sure will work. One possibility is that an agreement, rather than a contract, could be drafted between a governor and the Obama administration to establish a state’s exchange. Others are looking into whether the Department of Health and Human Services could say states have established their own exchanges already by helping the federal government operate an exchange on a state's behalf.
That all depends on the definition of "establish," and whether the Obama administration working with states on this premise wouldn't just end up in another lawsuit over the semantics of the law. Since the administration has repeatedly said that it doesn't see a quick, administrative fix to the potential problem the Supreme Court could create, that doesn't seem to be an option it's taking seriously.
Previous reports from the meeting highlighted the officials' discussions about potentially teaming up with other states to share exchanges, an option that also presents many hurdles. The primary one, these state officials seem to agree, is politics. Even if there's a silver bullet out there for fixing this problem the court could create, it would have to overcome the opposition of Republican governors and legislatures.
It's abundantly clear that the Republican Congress will not create a workable plan. State bureaucrats won't have many options either, in the face of political opposition. It's hard to predict anything other than total disaster for the 8 million or more people who could be losing their insurance if the court does its worst.