Congressional Republicans Consider Extending Subsidies as King v. Burwell Contingency

Republicans in the House and Senate are crafting separate plans that would extend subsidies for limited periods of time if the Supreme Court rules in favor of the plaintiffs in King v. Burwell, reports Politico. The Senate plan would extend subsidies through a currently undefined period of time and repeal the Affordable Care Act’s individual and employer mandates. Senate Finance Chairman Orrin Hatch (R-UT) and Senator Lindsey Graham (R-SC) have acknowledged that subsidies could be extended through 2017, when a newly elected President would be responsible for a replacement plan. The House plan would provide subsidies through 2015, and by 2016 would allow states to opt out of all ACA regulations and to potentially receive block grants to set up a health program or help residents purchase a plan on or off the Marketplace. This program would also expire in 2017. There has been no clear consensus among congressional Republicans about how to handle potential King v. Burwell fallout, with at least three contingency bills proposed in the Senate.

Arkansas, Delaware, Pennsylvania Receive Contingent Approval to Create State-Based Marketplaces

CMS sent letters to the governors of Delaware and Pennsylvania granting conditional approval to operate State-based Marketplaces in 2016. This provides both states with the ability to preserve subsidies for residents who currently receive them if the Supreme Court rules for the plaintiffs in King v. Burwell. CMS also conditionally approved Arkansas to operate a State-based SHOP marketplace in 2016 and a State-based individual Marketplace in 2017. State legislation (SB343) signed by the Governor prevents implementation of the State-based Marketplaces before a Supreme Court decision in King v. Burwell is made, and if federal subsidies are not permitted through, the legislature has the authority to reassess the State’s Marketplace options and must reauthorize the policy to implement a State-based Marketplace.