As the Supreme Court gets set to hear oral arguments next month in King v. Burwell, a case challenging the permissibility of subsidies to those who purchase health insurance on the federal exchange, states with hybrid exchanges could face a difficult decision should the Supreme Court ultimately rule the use of tax credits on the federal exchange is impermissible.
At least five states Iowa, Illinois, Arkansas, Delaware and New Hampshire have opted for state-federal partnership exchanges, according to data from the National Conference of State Legislatures. Under this hybrid model, people enroll through Healthcare.gov but the states retain control over administering certain aspects of the exchange.