HONOLULU (AP) — Hawaii officials are scrambling to provide information to the federal government to satisfy concerns about financial problems at the state’s health exchange.
All state-run insurance exchanges that are part of President Barack Obama’s Affordable Care Act are supposed to be financially sustainable this year. But without an infusion of cash, the Hawaii Health Connector won’t have enough money for its operations. The Legislature hasn’t yet approved the organization’s request to issue $28 million in bonds or loans.
Without a solid path to sustainability in place, the federal government is telling the state it may have to eventually move some technology functions to a federal system, said Jeff Kissel, CEO of the Hawaii Health Connector.
“This is a contingency that is being imposed on any state-based exchange that doesn’t have a funded sustainability plan in play,” Kissel said. “I don’t know of any other exchanges that are having to do this because it seems to me that everyone else is funded.”
Earlier this year the U.S. Supreme Court heard arguments in King v. Burwell, a case critical to the future of the Affordable Care Act (ACA, or so-called Obamacare). Readers interested in the details of the case should find them elsewhere. Suffice it to say here that the case concerns whether individuals can receive tax credits for buying health insurance on exchanges established by the federal government, though the text of the ACA indicates such subsidies are provided for those buying coverage through an “exchange established by the State.”
The case has the potential to invalidate substantial subsidies now being provided by federal taxpayers to millions of Americans using federal exchanges in 37 different states. Given the uncertainty created by the pending case, legislators on both sides of the aisle are considering how to react to various possible scenarios arising from a court decision. The House and Senate each recently passed budget resolutions allowing budget targets to be revised in the event of subsequent legislation modifying the ACA. The Senate resolution specifies that such legislation must be deficit-neutral.