President Barack Obamas administration says it has no contingency plan if the Supreme Court strikes down the health laws individual mandate.
The best fixes would be legislative but thats not likely when half of Congress wants to repeal whatevers left of the law.
Yet health experts say the administration does have a handful of backstops. The problem? Theyre pretty weak.
Here are four options the president could invoke to try to cover more Americans and why they wouldnt resurrect the full strength of the laws individual mandate.
1. Selling those subsidies
An aggressive outreach or marketing campaign might make the case to younger and healthier people that its a good deal for them to buy insurance, especially since many could qualify for subsidies to help them pay insurance premiums. Thats important because insurance companies cant sustainably cover more sick people without also having healthier people pay in.
If the individual mandate only is stricken, its not that big a deal, said Tim Jost, a National Association of Insurance Commissioners consumer representative. The premium subsidies, he argued, could be enough to entice uninsured healthy people to buy coverage. Thats especially true in the first couple years after the law takes full effect in 2014, when the penalty for not having coverage is so low its unlikely to change many peoples behavior.
But other experts are more worried about potential instability in the insurance market. After all, if a good PR campaign was all that is necessary, the administration wouldnt have fought for the mandate. Families USAs Ron Pollack, for instance, agrees that outreach can help but that it wont completely fix the problem. Outreach, he said, ameliorates I dont say corrects the possible imbalance of the market.
2. Late enrollment penalties
A ruling that eliminates the individual mandate, with or without some related insurance rules, would leave in place the health laws insurance exchanges, the new state-based insurance marketplaces. And the Department of Health and Human Services is setting some of the rules for the exchanges and the health plans that want to do business in them.
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4 health care options post-SCOTUS
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