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Officials, experts say Affordable Care Act subsidies likely to survive US Supreme Court case


The more than 80 percent of Delawareans eligible for insurance subsidies under the Affordable Care Act Marketplace could find themselves facing much higher premiums depending how the U.S. Supreme Court decides a case challenging to President Obama’s signature health care law.

The nation’s court heard oral arguments this week in King v. Burwell, which calls into question whether subsidies for insurance can be provided in states that have not set up their own exchanges.

Delaware is one of a handful of states that has a hybrid system managed by both the federal and state governments. State health Secretary Rita Landgraf says she is confident Delaware would be counted as a state exchange in the event the Supreme Court decides with the plaintiffs in King v. Burwell.

“We do the plan management, just like a state-based marketplace would, and we certify the plans,” Landgraf says. “We also do the consumer outreach, even though the federal government does allow for navigators, the state of Delaware actually created”

John Culhane, a distinguished professor at the Widener University School of Law, says the First State still may have a way forward even if the Supreme Court ruling finds Delawareans ineligible for those subsidies.

“Delaware is a case where the state may either argue they can continue the subsidies,” he says, “or they could take the more secure step and just convert this to a state exchange as quickly as possible.”

Culhane adds that as the state government is largely run by Democrats who are more inclined to be favorable to President Obama’s health law, taking the necessary steps to change the Delaware Marketplace to a state exchange should be less of a challenge than elsewhere.

Almost 25,000 Delawareans signed up or re-enrolled for insurance during the Affordable Care Act’s second open enrollment period.

The Supreme Court is expected to decide on King v. Burwell this summer.