Two states have announced backup plans in the event that the Supreme Court strikes down Obamacare subsidies this month, and other states are also considering their options,
The Hill reported.
Pennsylvania and Delaware announced they would launch their own exchanges if necessary to continue receiving millions of healthcare funds — while at the same time continuing to use portions of the federal healthcare exchange, such as its website and call center.
If the plans are approved, other states could use the templates to follow suit.
"I think that's a pretty easy workaround," Tom Scully, former director of the Centers for Medicare and Medicaid Services (CMS) under the Bush administration, told The Hill.
"The administration has a lot of flexibility, potentially, to define a state exchange."
But the arrangement could be a problem for Republicans who are hoping that the
outcome of King v. Burwell will strike a fatal blow for the federal healthcare program.
According to The Hill, many of the 34, and possibly 37, states that would be affected have been working on contingency plans if the Obama administration loses its case. And more and more states are considering the purchase of Obamacare technology from the government so they can keep their subsidies.
"Some have suggested the state could designate the federal government as its agent and continue the status quo," said Chris Stadelman, communications director for West Virginia Democratic Gov. Earl Ray Tomblin, according to The Hill.
States such as Nevada, New Mexico, and Oregon, which are already sharing the federal government's technology, could be a model for other states, said Dan Crippen, executive director of the National Governor's Association.
In addition, a multistate exchange is another option and could cut costs, Crippen said.
Connecticut is already leasing its Obamacare technology to Maryland and is in touch with "eight to 10" other states that may be interested in doing so, said the commissioner, according to The Hill.
Scully predicted that many states will settle on the solution of hiring CMS as a contractor.
"You can hire whoever the hell you want as a contractor," he said, according to The Hill. "You can contract a bunch of people in Philippines to do a call center. Why can't you contract CMS for an exchange?"
Asked whether states could use other states' technology to set up exchanges, White House press secretary Josh Earnest said the question was "extraordinarily complicated" and he directed questions to the Health Department.
"As a general matter, what our professionals have said — those who are steeped in the details of the health law and who are aware of the legal arguments that underpin this policy — that there is no simple, straightforward administrative fix," he said, according to The Hill.
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