The health law was designed to cover the poorest people by expanding Medicaid, the federal-state program for low-income people. But the Supreme Court made that optional. The result in states that didn’t expand Medicaid is a gap, where some people make too much money to qualify for Medicaid but not enough to qualify for insurance subsidies.

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The Affordable Care Act is once again before the Supreme Court. This time it’s not about whether the government can force you to have health insurance or pay a penalty. It can. That is so “2012.”

Now, in the case of King v. Burwell, the meaning of six words in a thousand-page law is under scrutiny. Those words could determine whether millions of Americans can afford to buy health insurance.

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After a passionate debate, the Florida Senate passed a bill Wednesday that would let a half million people use billions in federal dollars to buy health insurance, and added new measures to address criticism from the House, chiefly that the program would end in three years.

A majority of Republicans supported the controversial health care bill. Earlier this week, a state economist said the plan would save the state money. A top state health official warned it was unclear whether more or less people would gain coverage under the bill.

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House conservatives are hinting at support for a temporary extension of Obama-Care subsidies if the Supreme Court cripples the law, even as they set up a working group to develop their own plan.

The high court is set to rule later this month in the case of King v. Burwell, which could invalidate subsidies for millions of people in at least 34 states using the federally run marketplace. Republicans say they need to be ready to address people losing their coverage, but have yet to coalesce around a plan.

Now another proposal is in the works. Members of the conservative House Freedom Caucus told The Hill they are setting up a group of four or five lawmakers, led by Rep. John Fleming (R-La.). The lawmakers will develop a plan meant to influence the main House working group led by Rep. Paul Ryan (R-Wis.) and two other panel chairmen, which Fleming complained is meeting in “secret.”

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The Supreme Court could wipe away health insurance for millions of Americans when it resolves the latest fight over President Barack Obama’s health overhaul. But would the court take away a benefit from so many people? Should the justices even consider such consequences?

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The unlikely epicenter of Obamacare lies in a solidly Republican working-class town just 10 miles outside the Miami stomping grounds of Jeb Bush and Marco Rubio.
The city of Hialeah — a Cuban-American neighborhood of Spanish speakers that is blanketed with Obamacare advertisements — enrolled more people under the Affordable Care Act than anywhere else in the country.

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Tom Price, the chairman of the House Budget Committee, is the latest Republican to unveil a conservative health-care plan to replace Obamacare. It’s a good plan, although it could be made better — and it helps to clarify some of the trade-offs involved in health policy.

Price’s plan would give people tax credits to buy health insurance. The credits would be based on age but not on income. Everyone between 35 and 50 would get $2,100 a year, for example. Both the Affordable Care Act and some other conservative health-care bills, such as the one proposed by Senator Orrin Hatch and colleagues, instead phase out tax credits with income. The credits could be used to buy insurance in a much less regulated market than Obamacare creates: No longer would insurance policies have to cover a federally approved list of essential health benefits, for example.

The plan has already elicited some reasonable criticism over the choices Price made.

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Several high-profile Republican governors are building pressure on Congress to come up with a plan if the Supreme Court decides to void subsidies for millions of people in their states.

Florida Gov. Rick Scott and Wisconsin Gov. Scott Walker both said Tuesday they are opposed to any kind of state-level fix to restore ObamaCare subsidies in case the administration loses in court.

“I think it has to be a federal fix,” Scott told reporters at the event he hosted Tuesday for GOP presidential candidates, according to The Washington Post.

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The Supreme Court could decide this month that the financial help 6.4 million Americans receive to cover their health insurance costs are illegal — sending premium costs skyrocketing as much as 650 percent in states with some of the poorest residents.

The case, King v. Burwell, would affect people in the 36 different states that use Healthcare.gov as their marketplace. But the pain won’t be felt equally, according to a new graphic from the Kaiser Family Foundation, a health-care nonprofit with a wealth of data. The real losers in a ruling against Obamacare: the states that have the most people enrolled under the law and where incomes are low.

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If Republicans get their way at the Supreme Court this month and wipe out Obamacare premium subsidies for millions of Americans, the ensuing damage to their party in 2016 swing states could be poignant.

A state-by-state analysis by the Kaiser Family Foundation found that about 6.4 million Americans in 34 states that use the federal marketplace would lose a total of $1.7 trillion monthly tax credit dollars—an average of $272 per person—and face a net premium increase of 287 percent.

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