In some states, proponents of the health law are evaluating whether their governors could act without their legislatures. Within state legislatures, bills designed to maintain insurance coverage for residents and bills aimed at preventing a backup plan are competing for attention. Some state legislatures are considering both at once.
The case, King v. Burwell, challenges the wording of the Affordable Care Act. Opponents of the law argue the wording of a passage in the law restricts federal subsidies that make coverage affordable for most enrollees to the 16 states that operate their own online marketplaces.
The Obama administration, Democratic attorneys general and many major health-care companies argue that reading contradicts the framework and intentions of a law designed to expand insurance coverage to millions of people. They're also citing legal precedents that give deference to executive branch agencies to interpret acts of
About 87 percent of the 11.4 million people covered through the federal exchange receive federal subsidies that greatly offset the costs of their insurance, according to the
"This bill could be amended simply to insure the legislature has a full and fair discussion of health exchanges before they're created," he said.
"We do have that tension going on in this legislature," she said.
But some states are exploring just how much support they really need from their legislatures. Rules from the
"Our understanding is governors have been doing this by executive order," said
But others suspect it's not possible to cut the legislature out. Gov.
An advocacy group with a similar focus in
"We could very well wind up in a special session deciding how we're going to find some modicum of health care for up to 400,000 people," said state Sen.
States that already set up their own exchanges had the help of hundreds of millions of dollars in federal grants. States that are now considering setting up exchanges won't, which could mean having to find money for staffing and other functions. State exchanges are responsible for regulating health plans, consumer outreach, maintaining a website and handling enrollment. But several states, including
That's led some health experts to argue the states that already do handle plan management and other functions could become state-based exchange without the more costly technological aspects of running an exchange.
"I think somebody is going to propose it, but I don't know -- given personalities in the House -- [if] it'll get out of committee," said
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