- Associated Press - Monday, May 11, 2015

CHEYENNE, Wyo. (AP) - The U.S. Supreme Court plans to rule soon on a legal challenge to the federal Affordable Care Act that could imperil health insurance coverage for millions of people around the country, including more than 20,000 residents of Wyoming.

The court heard arguments in March in King v. Burwell, the most recent challenge to the federal Affordable Care Act - the federal law that requires citizens to maintain health insurance and mandates federal tax subsidies to help low-income people pay for it.

A ruling could come as soon as next month in the case that challenges the constitutionality of federal tax subsidies for residents in Wyoming and more than 30 other states.

The case targets programs in states that didn’t set up their own Internet exchanges where residents can shop for insurance coverage and instead rely on the federal healthcare.gov site.

States that operate their own exchanges wouldn’t be affected. Wyoming officials say they’re weighing options for how to respond depending how the court rules.

Gov. Matt Mead said Monday a major question is whether, if the Supreme Court ruled the federal exchange is impermissible, it would give Congress time to act to change the law.

“The concern is, if they postpone it, will be sort of a run on the bank,” Mead said. “In other words, people will sort of stop paying their premiums but go get the knee surgery. If they stop it immediately, they have 20,000 plus people who presumably are no longer going to have insurance that they’ve been having.”

Some insurance industry officials say many people in Wyoming wouldn’t be able to afford coverage without the subsidies.

As of March 15, over 21,000 Wyoming residents had signed up for health insurance coverage through the federal insurance exchange, Wyoming Insurance Commissioner Tom Glause said. The figure represents a 176 percent increase over last year.

“People are enrolling so the numbers speak for themselves,” Glause said. “People are getting used to the idea of coverage being mandated, and more are seeking insurance coverage in the marketplace.”

The average cost of coverage for an individual Wyoming resident is $550 while the average advanced premium tax credit covered $388 of that amount, Glause said.

Glause said he plans to brief members of a state legislative committee on the issue next month. He said options include doing nothing, creating a state exchange or partnering with another state to create an exchange.

Two companies offer health insurance through the Affordable Care Act in Wyoming: Blue Cross Blue Shield of Wyoming and WINhealth.

Steve Goldstone, CEO of WINHealth in Cheyenne, said his company has enrolled about 9,500 people through the exchange, with about 90 percent receiving federal subsidies covering about three-quarters of the cost.

“It’s highly unlikely that many of them would be able to afford the premiums without the subsidy,” Goldstone said.

Goldstone said it’s clear the federal law is helping the state.

“If you take the politics out of it, there are approximately 20,000 people in the state of Wyoming who are getting coverage that didn’t have coverage before, that can’t be bad,” Goldstone said. “Providers are getting paid for care they used to give away for free, or they called uncompensated. That can’t be bad.”

Goldstone said he served on a Wyoming task force that concluded a few years ago that it wasn’t feasible for Wyoming to develop its own exchange or partner with another state given the state’s small population and other factors.

Mead also said he believes the prospects of the state setting up an exchange are low because of high cost.

State Sen. Charles Scott, R-Casper, chairman of the Wyoming Legislature’s Senate Labor, Health and Social Services Committee, agreed.

“If they expect us to do a full-blown state exchange, then we just can’t, and we’d have to look for other solutions,” he said.

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