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Millions of Americans get subsidized health insurance under the Affordable Care Act. But those subsidies are being challenged. And in the coming weeks the Supreme Court could rule that in more than 30 states, the subsidies are illegal. To find out what federal and state lawmakers could do if the subsidies disappear, we spoke to Linda Blumberg, a senior fellow at the Urban Institute, an economic and social policy think tank. This is a lightly edited transcript of the conversation. (Cornish, 5/11)

WNPR's Jeff Cohen, working in partnership with Kaiser Health News and NPR, reports: "The politics of the Affordable Care Act in the state of Louisiana are not subtle: It is not popular. The state was part of the lawsuit to strike down the law in 2012; it didn’t expand Medicaid and has no plans to, even as other Republican-led states have done so. And Louisiana didn’t set up its own marketplace to sell Obamacare insurance." (Cohen, 5/11)

The Centers for Medicare and Medicaid Services will host state-based health law marketplace officials this summer in a conference to talk about the exchanges' financial viability, federal marketplace CEO Kevin Counihan on Monday. This is the first year in which state-run marketplaces must be financially independent, and several are struggling. A number of states use taxes on health insurance as a major revenue source, but health insurance industry officials are pushing back against increases. (Adams, 5/11)

A report scheduled for release Monday by a conservative-leaning think tank accuses state officials of misleading the federal government and the public about the Massachusetts Health Connector’s readiness to launch its new website in October 2013. The report from the Pioneer Institute draws on public audit reports and interviews with anonymous people described as “whistle-blowers” to detail what they characterize as a bungled effort by the University of Massachusetts Medical School, software developer CGI, and the Connector to upgrade the Connector’s software in 2012 and 2013. (Freyer, 5/11)

The state was aware for more than a year that the updated version of its health connector website was well behind schedule and may have tried to conceal that knowledge from the public and the federal government, a report suggests. The Pioneer Institute, a conservative-leaning think tank, said the report it released Monday was based on discussions with whistleblowers and information from publicly available audits. (5/11)

Colorado health exchange managers want board members to max out a broad market assessment on health insurance customers across Colorado through 2016 while also hiking fees on exchange customers from 1.4 percent to at least 3.5 percent — and possibly as high as 4.5 percent. “This is a really critical period. We need to become sustainable. We also need to make sure we have adequate sources of funding to keep the organization strong,” said Gary Drews, outgoing interim CEO for Connect for Health Colorado. Before the exchange board meets again later this week to vote, Colorado’s legislative oversight committee will meet on Wednesday to review Connect for Health Colorado’s finances and sustainability plans. (Kerwin McCrimmon, 5/11)

The Connect for Health Colorado staff has recommended more than doubling the fee that insurers pay on each policy purchased on the exchange — a charge that is passed on to consumers. The state marketplace would increase the carrier fee from 1.4 percent to at least 3.5 percent of the premium charged on exchange health plans — the same rate charged through the federal exchange, under the recommendation made Monday. (Draper, 5/11)

The cost of health insurance could increase 5.4 percent on average for people buying individual coverage next year — the lowest requested increase in Washington state in eight years. And there could be even greater choice for consumers with more insurance companies in the market and more plans proposed for 2016. But many people will need to choose new plans, as most of the options that were available this year are being substantially changed or canceled. (Stiffler, 5/11)

Minnesota should consider ways to make the federal health law work better by seeking an “innovation waiver,” a national expert on health insurance exchanges said Friday. Joel Ario, who previously served as the top Obama administration official for the new insurance marketplaces, told a University of Minnesota forum on Friday that the federal Affordable Care Act [ACA] includes a waiver program so that states in 2017 can start customizing aspects of the health law. Such a waiver could allow Minnesota to address ­coverage “cliffs,” including the difference in out-of-pocket spending for people covered through public health insurance programs and those who buy private coverage on the MNsure exchange, said Ario, a managing director at Manatt Health Solutions. (Snowbeck, 5/11)

A technical problem related to the MNsure IT system means the state must rerun eligibility determinations for more than 55,000 people in public health insurance programs. There is no immediate impact for people in the Medicaid and MinnesotaCare programs, state officials said Monday, but there’s a chance some in the future will need to find a new source of health insurance. There’s also a chance the state could be at risk financially if people wrongly received coverage through the programs, which are partly funded by the federal government. (Snowbeck, 5/11)