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Conventional wisdom says big corporations that employ lots of people in a state generally call the shots with local politicians, especially when those corporations are the source of major campaign contributions. But that's not the case in Tennessee. At least when it comes to Obamacare. Tennessee is looming as ground zero for the political fallout from the Supreme Court's decision, which could come as early as Thursday, on the insurance subsidies at the heart of President Barack Obama's health care law. Some of the nation's biggest hospital chains are based in the Volunteer State and stand to lose hundreds of millions of dollars if the justices invalidate the subsidies. Yet they haven't been able to make the state's Republicans budge off their stance against the health care law. (Tracer, 6/23)

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. (Evans, 6/23)

The future of health insurance premiums on the federally run marketplace is rife with uncertainty, and Tennessee's insurance commissioner is headed to Washington, D.C., to talk about it. Insurers are beginning to get a view into how people who buy insurance on the exchange use insurance, but a U.S. Supreme Court case set to be decided in the coming days could throw the nascent system into disarray. (Fletcher, 6/23)

About 160,000 low- and moderate-income Indiana residents could lose health insurance premium subsidies provided under the Affordable Care Act if the U.S. Supreme Court rules them illegal, two groups estimated Tuesday. The nonpartisan Kaiser Family Foundation and Families USA, an advocacy group for affordable health care, both based their estimates on data provided by the U.S. Department of Health and Human Services. (6/23)

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. (Biello, 6/23)

Even if the court rules in favor of the plaintiffs trying to gut the law, imperiling the subsidies 6.3 million people are using to help pay their insurance bills, the decision should have no immediate effect on California and other states that have set up their own state-run exchanges. ... But that doesn't mean the Golden State's exchange, called Covered California, doesn't face other significant challenges, from trying to build up its enrollment numbers, to the end of federal revenue guarantees for health insurance companies that agree to participate in the exchange -- something observers say could cause premiums to spike. (Seipel, 6/23)

The Supreme Court will issue a decision on President Barack Obama's signature healthcare law any day now, and Justice Anthony Kennedy made a telling comment in March that could signal how he will vote. 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. (Fuchs, 6/23)