While there has been much hoopla about the looming Supreme Court decision about whether it's legal for people in 34 states that didn't set up their own healthcare exchanges to receive subsidies to help them afford health insurance, the 13 states that run their own Obamacare exchanges are in a quandary of their own, according to
The Hill.
States are required to be financially self-sufficient by 2016 or they will have no choice but to join the federal exchange, HealthCare.gov. Until now, states have been bolstered by $5 billion in grant money to help launch exchanges. Several states, including Oregon, Nevada, and New Mexico, have already scrapped their own exchanges,
The New York Times reported in March.
Those states are looking into joining with one of the 13 states that runs their own marketplace, according to The Hill.
In an effort to cut costs and remain sustainable, officials in some of those 13 states
— Maryland, Connecticut, Rhode Island, Vermont, Massachusetts, New York, Kentucky, Minnesota, Colorado, Idaho, Washington, Hawaii, and California, and the District of Columbia
— are considering
multistate exchanges, though the logistical and regulatory hurdles are enormous, according to The Hill.
Jim Wadleigh, the CEO of Connecticut's exchange, told The Hill that he has had discussions with other states, including Vermont, and Rhode Island, about partnering. Some states are also looking at switching to the federal exchange, he added.
Some of the prospects are a shared call center or website platform, though figuring out how to split costs and responsibilities presents a challenge.
A "technology-sharing system, where multiple states all hire the same private contractor" may be a more practical solution, according to industry experts, as well as a regional call center or outreach team.
The logistical challenge is so great that Delaware, Maryland, and West Virginia rejected the idea after commissioning a study on it in 2013, according to The Hill.
"In the last seven business days, I've probably had seven to 10 states contact me about contingency plans," said Wadleigh of Connecticut, a state exchange that is hailed as a success.
If the U.S. Supreme Court rules against the Obama administration in the King v. Burwell case
— the plaintiffs argue that Obama's Affordable Care Act only allows for federal subsidies on state-run exchanges, not those states that use the federal exchange
— some 7.5 million people stand to lose their subsidies, according to the Times.
On average, federal subsidies cut monthly premiums by 72 percent, according to
The Washington Post.
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