START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

Wall St. Journal: Officials from a bunch of states held Secret King v. Burwell meeting. Conclusion? ¯\_(ツ)_/¯

This isn't quite as big of a shocker as it would have been if The Hill's Sarah Ferris hadn't already posted a related story about a week ago, but it's still a nice scoop by Louise Radnofsky and Stephanie Armour:

Officials from states across the nation flew to Chicago in early May for a secret 24-hour meeting to discuss their options if the Supreme Court rules they have to operate their own exchanges in order for residents to get health-insurance subsidies.

Over the course of an evening reception, a day’s presentations and a Mexican buffet at the O’Hare International Airport’s Hilton hotel, some of those officials concluded their options are likely unworkable.

Unfortunately, for all the Top Secret Urgency, their conclusion was pretty grim...

There is little chance most of the states that use HealthCare.gov could set up their own exchanges fast enough to preserve residents’ tax credits, participants said after the meeting. Several also said that while officials talked about ideas such as leasing an exchange from the federal government or a state that has its own, the hurdles could be too high to overcome.

Aside from the time factor (which could have been partially mitigated if they had moved a little quicker...like, say, last November when the Supreme Court agreed to take up the case in the first place), the bigger problems are a) funding and b) political will, of course:

Participants said it was extremely unlikely their state governors, legislatures and insurance commissioners would all agree to set up an exchange if the Supreme Court struck down their state subsidies, and that they could do so before the subsidies could vanish.

(As an aside, the Hawaii exchange keeps insisting that their private healthcare policy enrollment is anywhere from 35,000 - 40,000, even though they only had around 13,000 as of late February. I've yet to figure out what the heck is going on there.)

But several attendees in Chicago said they doubted their governors or legislatures could agree to such an option amid opposition to the health law, especially from Republicans. Of 34 states that didn’t set up their own exchanges, only seven currently have Democratic governors, and only one of those also has a Democratic legislature.

Pennsylvania Governor Tom Wolf is on the record as supporting a state exchange, and I received word today that Delaware (the 1 state with an all-Dem administration referred to above) has also asked the HHS Dept. to let them piggyback their official exchange on HC.gov. No surprises in either case, and Wolf still has to deal with an all-GOP legislature.

As for the rest, not only are they refusing to budge, a few (such as Arizona) have even passed laws preventing an exchange from being established (which is kind of redundant since they'd have to agree to set it up anyway, but still...)

In many of the rest of the states, GOP legislators have taken steps to block any moves from even Republican governors to implement the law. Those legislators might be able to bar the state from entering into any contract or lease to get exchange technology, some officials say.

In short, the Republican Party has decided not just to slit their own throats, but to block anyone else from trying to grab the knife.