LEBANON, N.H. (AP) -- A leader of the effort to revamp Vermont's health care system said Monday the state will cope better than most if the U.S. Supreme Court guts President Barack Obama's health care law, but its reform efforts could be hurt by a loss of more than $200 million a year in federal subsidies.

Anya Rader Wallack, chair of the Green Mountain Care Board, made the comments during an appearance before about 40 physicians, administrators and staff at the Dartmouth-Hitchcock Medical Center. The "grand rounds" meetings are designed to keep health professionals up to date on trends in their field.

The effort by Gov. Peter Shumlin and the Legislature to push Vermont toward a publicly financed health system in which as many claims as possible are processed through a single payer could have a big impact at the Lebanon teaching hospital, which is just across the Connecticut River from Vermont and gets about 40 percent of its patients from that state.

And the federal law's fate likely will have a big impact on Vermont's envisioned Green Mountain Care plan.

The state passed a law last year designed to move Vermont toward but not all the way to a Canadian-style, single-payer health care system by 2017. Likely exceptions include federal employees living in the state and those working for "self-insured" employers

This year, lawmakers designed a health care "exchange," or marketplace, that will be the Web-based, one-stop shopping portal for consumers to compare plans and buy health insurance beginning in 2014.

But a linchpin of financial support both for the exchange and for the Green Mountain Care system planned for later are tax credits to be available under the federal law that have been counted on to help people buy health insurance in the exchange.

Wallack said one early estimate put the value of those tax credits at between $200 million to $300 million per year in Vermont. Other hoped-for federal funding for things like new computer systems to process patients' health records also could be in jeopardy, she said.

Much anticipation surrounded Monday's release of Supreme Court decisions because it was believed the federal health care law ruling might be among them. It wasn't, and the next time the court releases decisions is Thursday.

There's been speculation that the court could leave the multi-faceted law intact, strike down its most hotly debated provision a mandate for individuals to buy health insurance or overturn most or all of it.

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Vt. health official visits with NH doctors