Wednesday Short Cuts

• Obamacare dilemma for GOP govs running for president

If the Supreme Court rules against Obamacare subsidies, the four governors running for president will face a harsh choice: Let tens of thousands of people get kicked off their health plans, or try to create a state exchange and lose credibility with a virulently anti-Obamacare Republican primary base.

Louisiana’s Bobby Jindal, Wisconsin’s Scott Walker, New Jersey’s Chris Christie and Ohio’s John Kasich all refused to set up Obamacare exchanges, as did most other GOP governors. Their states would be directly affected if the court rules that the health law’s subsidies can go only to people living in states that did establish the new online Obamacare markets.

As Jeffrey Young would put it, "Just In Time!!":

• Republicans Don't Have A Plan Yet To Replace Obamacare Subsidies

If GOP lawmakers get the court decision they've been hoping for, it will be up to the Republican-controlled Congress to figure a way out of the mess. After more than 50 votes in the House to repeal either all or parts of the Affordable Care Act, Republicans have yet to unveil a proposal on how to replace the health care law. And they also haven't united around a stopgap plan that would bridge an adverse ruling by the court with the health care policies of the next president.

I didn't even need to read this one; it's pretty much identical to similar stories in 33 other states this week:

• SCOTUS Decision on Healthcare Subsidies Could Disrupt N.H. Insurance Market

The United States Supreme Court is expected to decide a case this month that could be do or die for President Obama’s signature healthcare law. At issue are the subsidies available to people who purchase insurance plans on Healthcare.gov, also called the healthcare exchange. New Hampshire is one of 37 states using this federally-operated insurance marketplace, and if the Supreme Court rules in favor of the plaintiff in the case, about 30,000 people in New Hampshire may see their subsidies disappear.

• Daniel Weintraub: State has to ante up for health care enrollment surge

State and federal spending on health care in California has nearly doubled in the past seven years. Yet state lawmakers are meeting this week to consider raising taxes to spend even more. What’s going on?

The answer lies largely in the rapid expansion of the Medi-Cal program, which will soon provide health care to nearly 1 in 3 Californians. At the same time, the federal government has disallowed a creative financing scheme the state was using to maximize federal money for the program.

This statement made some waves back in March, but it doesn't necessarily mean anything whatsoever:

• This comment from Justice Kennedy could signal the fate of Obamacare

Kennedy, a key swing voter, said during oral arguments that he saw a "serious constitutional" question with the interpretation of the Affordable Care Act (ACA) set forth by the plaintiffs who are trying to strike it down.

"If that's Kennedy's view of the case, there's almost no chance that the challengers can win," UCLA constitutional law professor Adam Winkler told Business Insider at the time.

The Des Moines Register is none too thrilled with David King, the "King" in "King v. Burwell"...

• Editorial: Obamacare ruling could affect millions, except for plaintiff

So who is this plaintiff? How will King be personally affected by the ruling?

Apparently he won’t. King told the New York Times last week he’s not really worried about the outcome of the case and didn’t attend the oral arguments in early March. He is a veteran and has access to medical care through the Department of Veterans Affairs.

That’s right. The man who made it a priority to potentially strip Americans of taxpayer help obtaining private health care can receive his own care through a government medical system completely funded by taxpayers. And King says people are essentially crying wolf about the potentially devastating impact of the ruling, because his lawyers assured him “things are in play to take care of the problem.”

Really? Perhaps he could enlighten the public about what exactly those “things” are.

• Feds Grant Flexibility To Other States As Kansas Awaits Ruling On Subsidies

In Kansas, where Republicans hold supermajorities in both chambers, 70 GOP legislators recently signed a letter stating they would not establish a state-based exchange and urging Congress to “reconsider or re-examine Obamacare.”

A statement released Monday from Sen. Mary Pilcher-Cook and Rep. Dan Hawkins, who head the Legislature’s health committees, went further, urging Congress to repeal the law entirely.

• House Committee Will Work Off-Session To Assess Vermont Health Connect

It was with much fanfare earlier this month that Gov. Peter Shumlin announced the long-awaited arrival of a new piece of technology at Vermont Health Connect, the troubled health care exchange. Shumlin says the software will allow the state to process changes in customers’ insurance status more quickly. And he says it will alleviate a customer-service backlog that has caused accounting errors, wrongful policy terminations, and in some cases delayed access to care.

But House Speaker Shap Smith says he needs more evidence before he’s convinced the program is fixed. And before sounding the final gavel on the 2015 legislative session, Smith authorized the House Committee on Health Care to meet several times over the summer and fall.

• Hospital cost of uninsured: $900 per patient, per year

New research suggests the financial strain on hospitals and households will be immediate and significant if a U.S. Supreme Court decision ends subsidies for health insurance in 36 states. As many as 6.4 million Americans who bought insurance may drop it and become a financial burden to providers. 

The study, published by the National Bureau of Economic Research, found a “minimum and unavoidable” demand for hospital care among the uninsured at an annual cost to hospitals of $900 a patient.