STATES COULD POSSIBLY "LEASE" HEALTHCARE.GOV

CHICAGO, IL - June 16, 2015
A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.

President Barack Obama has said there is no backup plan if the Supreme Court strips federal subsidies from the law in Illinois and the 33 other states that haven't created their own exchanges. The administration didn't respond Monday to the AP's requests for comment on the possibility of leasing HealthCare.gov.

"We do believe that the administration is quietly discussing a healthcare.gov lease option with the states and that it will roll out more specific guidelines in the event that the Supreme Court strikes down the subsidies," said Caroline Pearson, who follows the health law for the market analysis firm Avalere Health.

The four-page Illinois memo is the clearest plan yet for how the state could create a state-based exchange quickly should the justices rule that only people living in states with their own exchanges can get federal financial help.

The Supreme Court ruling is expected later this month, and the subsidies could end later in the summer unless Congress acts. Leading congressional Republicans are promising to help consumers who lose subsidies, but it's unclear Congress could pass any fix that Obama would sign.