Wednesday, March 18, 2015

If SCOTUS Rules for Plaintiff, What Happens Next?


By Steve Davis - March 17, 2015

For the record, I don’t think the Supreme Court will decide only state-based exchanges can distribute federal premium subsidies. The court had its chance to strike down the individual mandate in 2012 but didn’t.

But if I’m wrong, will a decision against HHS mean the end of public insurance exchanges and an unraveling of the Affordable Care Act (ACA)? Probably not. But it certainly would force Congress, state lawmakers, HHS and insurance carriers to do some serious scrambling this summer. In the absence of a stay, subsidies, which are distributed monthly to carriers, would dry up almost immediately if the court determines federally run exchanges can’t legally distribute them. If the verdict comes out in late June, as expected, it’s unlikely Congress would be able to agree on a solution before heading out of Washington for summer recess.

Here are a few scenarios that could play out:

·  Congress votes to amend the language of the ACA allowing subsidy distribution to remain as is.

·  Congress creates a bill allowing federal subsidies to continue IF the individual and/or employer mandates are eliminated.

·  Congress blames the problem on the administration and the former Democratic majority…and goes on vacation.

·  HHS allows carriers to submit alternate 2016 rates to account for the healthy population that drops coverage. Most carriers drop out for the 2016 plan year.

·  HHS releases a rule allowing early use of the ACA’s 1332 waivers, which give states some flexibility to come up with their own strategies to reform insurance markets.

·  State legislatures hold emergency sessions and vote to allow a transition to a federally supported state marketplace model.

What do you think? Will the Supreme Court rule against HHS in King v. Burwell? If that happens…what happens next?

No comments:

Post a Comment