As the country awaits a Supreme Court decision that could affect health insurance for millions of Americans and about 200,000 Missourians, many states are preparing for the potential fallout. Missouri isn’t among those states.
The high court is deciding whether the Affordable Care Act allows government subsidies for all consumers who buy health insurance. Plaintiffs in the case say the law limits such subsidies to consumers in states that have set up their own health insurance exchanges. Missouri is one of about three dozen states that has not created its own exchange.
Some states without exchanges have made arrangements to set exchanges up if the Supreme Court rules against subsidies. That would enable continued federal subsidies for those states. But Missouri’s hopes of doing that are hamstrung by legislative opposition to the Affordable Care Act and a 2012 law preventing the governor from creating a health care exchange on his own.
Other states are exploring ways to operate the federal HealthCare.gov exchange in a way that gives them more local control, thus satisfying the requirement that states operate an exchange and helping them remain eligible for subsidies. But that also appears unlikely in Missouri.