Oklahoma Watch asked three experts with the Henry J. Kaiser Family Foundation in Washington, D.C., the largest health foundation in the country, about the political impact of today’s Supreme Court decision upholding Affordable Care Act health insurance subsidies.

The exchange occurred during a conference call briefing with health care reporters across the country. Here are their responses. They have been condensed slightly for the sake of brevity.

Oklahoma Watch: In states like Oklahoma where Republican officials have opposed almost every aspect of Obamacare and have shown no interest in creating a state-based exchange, will today’s ruling change the political equation?

Kaiser Senior Vice President Larry Levitt: I don’t think it changes the political equation relative to the status quo. If the decision would have gone the other way, it would have put red state governors in a very difficult spot. They would have had to choose between opposing Obamacare versus making sure that billions of dollars in subsidies were flowing to their residents. With this decision, governors are free to oppose the Affordable Care Act on political grounds. But that doesn’t have consequences for the subsidies. There’s still the question of Medicaid.

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State Health Reform Director Jennifer Tolbert: Currently 30 states have expanded the Medicaid program, leaving 20 states that have not yet expanded Medicaid. There are discussions in several states. It’s unclear whether [today’s ruling] will affect any of the decisions by legislatures and governors that have not yet expanded Medicaid. The Medicaid expansion can happen at any point. The 100 percent federal funding is available for one more year, through 2016. There’s still a great deal of federal funding available to the states should they choose to implement the expansion.

Senior Fellow Karen Pollitz: Oklahoma is one of a handful of states that has declined to enforce any of the insurance market reforms and has left that to the federal government. I think there are still several ways for states to decline to participate or try to throw up other roadblocks to successful implementation.


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