There is no official plan. There is no time to execute one, even if there were a plan. And, perhaps most importantly, there appears to be no political leadership in Florida to act if the Supreme Court rules this month that more than 6 million Americans, including about 1.3 million Florida residents, can no longer receive federal subsidies that help pay for their health insurance under the Affordable Care Act, according to health policy experts.
Many scenarios could play out if the Supreme Court rules that billions of dollars in health insurance subsidies, including an estimated $389 million a month for Florida residents, can only be distributed through exchanges established by a state, as the plaintiffs argue in King v. Burwell.
But absent a ruling that provides for a temporary extension of subsidies for residents of the 34 states that rely entirely on the federal exchange at HealthCare.gov, health policy analysts say any long-term solution comes down to state action — or Congress.
“There aren’t a lot of fallback options in place at this time," said Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation, a California-based health policy research nonprofit group.
In Florida, legislators have no official plan — though conversations have been taking place — and they likely will look to the federal government first for a solution if the Supreme Court rules for the challengers, said Diane Hilligoss, a University of Michigan law student and researcher who interviewed Florida lawmakers and others in the spring for a study published by Health Affairs, a health policy journal.