White House preparing health care contingency plan, sources say

White House preparing health care contingency plan, sources say link

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The Medicaid expansion was originally estimated to account for about half the more than 30 million people slated to get coverage under the law. Without a mandate, the number would be smaller but still significant.
Federal tax credits to help middle-class people buy private health coverage also would survive, as would new, state-based insurance markets.
Such subsidies have never previously been available, and millions are expected to take advantage of them, whether or not insurance is required by law. Still, it could be tricky to salvage the law's full blueprint for helping middle-class uninsured people.
Overturning the mandate would have harmful consequences for the private insurance market. Under the law, insurers would still have to accept all applicants regardless of health problems, and they would be limited in what they can charge older, sicker customers.
As a result, premiums for people who directly buy their own coverage would jump by 15 percent to 20 percent, the Congressional Budget Office estimates. Older, sicker people would flock to get health insurance, but younger, healthier ones would hold back.
To forestall such a problem, the administration asked the court — if it declares the mandate unconstitutional — to also strike down certain consumer protections, including the requirement on insurers to cover people with pre-existing health problems. That would mitigate a damaging spike in premiums.
Whether or not the court goes along with that request, more work would be needed to find alternatives to a federal mandate. That could provide an opening for state officials, as well as major insurance companies, to join in finding workable substitutes for the mandate. Congressional approval would likely be needed.
Without the individual requirement, about 14 million people would still get coverage, budget office estimates suggest. Supporters of the law point out that's still a lot of people.

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