This seems awfully familiar.
2018 MIDTERM ELECTION
Time: D H M S
Sec. Burwell responded in the only rational way possible: By pointing out that if [the Republican Party is] absolutely determined to destroy the lives of millions of likely voters across 34 states (including swing states like Florida, Ohio, Michigan and Wisconsin) while simultaneously forcing insurance premiums up an additional 35% - 45% for everyone else in those states (on top of whatever they were set to go up already), when it would literally take about 5 minutes for them to "fix" the very issue that they ginned up as the "problem" in the first place, there's not a hell of a lot that she can do to stop them.
...None of the above options involve anything that Sec. Burwell has any control over.
In other words, her only "contingency plan" is "try to convince the Republicans controlling the Supreme Court, Congress or those states to stop being colossal jackasses and actually do something to help the people they're supposed to be serving."
Not a plan likely to succeed, of course...but it's a plan.
...Yes, of course, it it does come to that, there's various negotiations that President Obama could discuss--the Medical Device tax, the SHOP exchanges, hell, even the Employer Mandate could theoretically be on the table....However, those would all still obviously require Republican action by definition.
And yes, as Sarah Ferris noted this morning at The Hill, the administration probably could provide a bit more guidance to the states about minimum requirements/procedures for "establishing" an exchange...However, again, that would still require the Republicans controlling those states to request the status change.
Burwell countered that there is not much the Obama administration can do at the moment, though she did refer to some planning efforts where previously the White House had given none.
"We’ll do everything we can, we’re working to make sure we are ready to communicate to the states and do everything we can," Burwell said.
Burwell raised the prospect last week, at a Wall Street Journal breakfast, of states working with HHS for help in setting up their own exchanges, allowing subsidies to continue.
But that solution would require state leaders to agree to work with HHS, which many Republican governors are reluctant to do.
"The critical decisions will sit with the Congress and states and governors to determine if those subsidies are available," Burwell said.