Marketplace confronts confusion in face of conflicting rulings

News outlets report that providers and insurers worry the two appellate court decisions could undermine the stability of the newly expanded health insurance markets. Meanwhile, governors in those states that opted not to set up their own marketplaces may face pressure if consumers who used healthcare.gov to shop for coverage lose their subsidies.

The Wall Street Journal: Hospitals, Insurers Say Subsidies Rulings Further Confuse The Issue
Health-industry officials said Tuesday's dueling court rulings over federal health-law subsidies set the stage for another bout of confusion as consumers return to marketplaces this fall to shop for next year's coverage. "People are going to be coming in with more questions about these court cases," said Jason Stevenson, a spokesman for the Utah Health Policy Project, a nonprofit organization that has navigators that aid residents in enrolling on the federal exchange. "People are already asking about the long-term stability of the ACA" (Wilde Mathews, Weaver and Armour, 7/22).

Modern Healthcare: Clashing Rulings On Exchange Subsidies Raise Fear of Instability
Healthcare providers and insurers fear that today's conflicting appellate court rulings on the legality of Obamacare premium subsidies offered through the federal insurance exchange could have a destabilizing effect on the newly expanded insurance market (Robeznieks, 7/22).

The Wall Street Journal: Some Governors Face Fallout Over Health Law Ruling
The prospect of millions of people losing federal tax credits they obtained under the health law places some governors and legislators in a tough spot in the run-up to this fall's elections. Some 36 states turned over the task of running the health law's insurance exchanges to the federal government. If courts ultimately back Tuesday's decision by a federal appeals court in Washington, D.C., which held that Americans can obtain tax credits only if their state is operating its own exchange, then officials in these states may come under pressure to find ways to ensure residents keep subsidies (Radnofsky and Peters, 7/22).

Politico: Democrats Still Haven't Learned Obamacare Lesson
The conflicting rulings were another wake-up call for Democrats about the fragility of the health care law -- and a reminder that whenever they think a lawsuit is no threat to the law, it's probably a threat to the law. It's all because of what most Democrats insist is a drafting error in the law, but it's kind of a big one. The federal health insurance marketplace is now serving 36 states that couldn't or wouldn't set up their own exchanges (Nather and Haberkorn, 7/22).

Meanwhile, a look at the courts --

Politico: How Obama's Court Strategy May Help Save Obamacare
Last fall, President Barack Obama and Senate Majority Leader Harry Reid deployed the "nuclear option" to help get three liberal judges onto the D.C. Circuit appeals court. Tuesday's ruling on Obamacare is a dramatic example of why they forced the issue (Gerstein, 7/22).

The Associated Press: Judges in Health Care Rulings Vote Party Line
In rapid succession, six federal judges on two appeals courts weighed in on a key component of President Barack Obama's health care law. Their votes lined up precisely with the party of the president who appointed them. It was the latest illustration that presidents help shape their legacies by stocking the federal bench with judges whose views are more likely to align with their own (7/23).