At Winter Meeting, Governors Admit No "Plan B" if ACA Subsidies Fall

States have no plan to deal with the fallout if millions of consumers lose their health insurance subsidies later this year, should the Supreme Court agree with opponents of the Affordable Care Act when they make their case next month.

Loss of premium subsidies was topic number one at this weekend’s meeting of the National Governors Association in Washington, D.C., where even Republican governors who opposed the ACA did not relish the prospect of hearing from angry constituents, who would suddenly be unable to afford their health coverage. Many admittd they had urged Congress to do something about it.

An estimated 8 million people could be negatively affected by King v. Burwell; oral arguments are scheduled for March 4, 2015. The case involves the drafting of the ACA, with plaintiffs asserting that only those consumers who live in states with their own exchanges can receive financial assistance. As it turned out, 34 states used the federal exchange, HealthCare.gov, and 87% of consumers who signed up for coverage through that exchange received a premium subsidy. Federal figures show the average subsidy is $268.

The ruling is not expected before late June.

Governors were quick to wash their hands of responsibility—even those who might aspire for higher office. “That responsibility doesn't fall in the hands of the states or the governors, it falls in the hands of the leaders right here in Washington," Wisconsin Gov. Scott Walker, who is contemplating a run for the Republican presidential nomination in 2016, told the Associated Press. He's one of the many Republican leaders who resisted efforts to create a state-based health insurance exchange.

Some thought that even if the court struck down subsidies in states without their own exchanges, the justices would give states some breathing room. Utah Gov. Gary Herbert, a Republican, predicted the chances of the Supreme Court striking down the subsidies are "maybe 50-50."

"My expectation is that they'll give us some time to adjust," Herbert said.

Republican Governor Nikki Haley of South Carolina told The Washington Post that her state was considering legislation to set up an exchange to protect more than 170,000 consumers who have premium subsidies.

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