This article has been updated with a correction.
State-based exchanges are reporting a robust number of sign-ups and renewals for health insurance during the current open-enrollment period, an analysis of state data shows. The 14 state-based exchanges are collectively reporting more than 854,000 people signed up or re-enrolled in coverage as of early January.
If that pace keeps up, states could surpass the roughly 2 million enrollees their exchanges saw last year. Combined with the nearly 6.6 million enrolled into coverage on HealthCare.gov, approximately 7.4 million have gained coverage since open enrollment began. HHS predicted 9.1 million individuals would sign up in the current enrollment period, which ends Feb. 15.
But looming over this sign-up period is the possibility that a U.S. Supreme Court decision could bring massive upheaval to the insurance landscape, said officials from four states that rely on HealthCare.gov to enroll and determine eligibility for coverage.
Representatives from Florida, Illinois, Michigan and Missouri on Thursday addressed the possible fallout from the King v. Burwell case during a Families USA conference call.
No efforts are in the works to establish state-based exchanges in any of their states. Also, local leadership isn't discussing any contingency plans should the court decide against the Obama administration and rule illegal insurance subsidies for those who secure coverage through HealthCare.gov, they said.
More than a million people in the four states selected plans through the federal exchange leading up to the Dec. 15 deadline for coverage beginning Jan. 1, according to HHS. The vast majority of those people received premium subsidies to afford coverage.
If the court rules subsidies illegal for federal exchange enrollees, it is likely Congress would intervene, hoped Jennifer Koehler, executive director of Get Covered Illinois.
“Given the potentially high percentage of consumers that could be impacted, the best solution would be a uniform one across the states,” Koehler said.
But between Republican control of Congress and the president's expressed unwillingness to make other changes to Obamacare that Republicans want, it's difficult to see the two sides compromising on such a major issue.
Eliminating financial assistance for low- and moderate-income individuals who purchase coverage through HealthCare.gov could cause individual market enrollment to drop by 70% among those buying policies from qualified health plans, according to a RAND Corp. study released Thursday.
Follow Virgil Dickson on Twitter: @MHvdickson
Correction: An earlier version of this story included an incorrect tally of enrollments in private plans through state exchanges.