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Officials from states across the nation flew to Chicago in early May for a secret 24-hour meeting to discuss their options if the Supreme Court rules they have to operate their own exchanges in order for residents to get health-insurance subsidies. Over the course of an evening reception, a day’s presentations and a Mexican buffet at the O’Hare International Airport’s Hilton hotel, some of those officials concluded their options are likely unworkable. (Radnofsky and Armour, 6/1)

The Supreme Court is heading into the final month of its annual term. ... Another much-anticipated decision will be whether the Obama administration may continue to subsidize health insurance for low- and middle-income people who buy coverage in the 36 states that failed to establish an official insurance exchange of their own and instead use a federally run version. If the court rules against the Obama administration, about 8.6 million people could lose their subsidies under the Affordable Care Act. Between now and late June, the court will hand down more than two dozen decisions on matters such as politics, civil rights, free speech and air pollution. Several of these cases have been pending for months, suggesting the justices have been sharply split. (Savage, 6/1)

Don’t expect the grousing about high-deductible health insurance to ebb anytime soon. A spate of recent reports confirms what many of us have been reporting: More and more, having health insurance doesn’t mean you’re protected against crippling bills. In the past year and a half, the Affordable Care Act has gotten millions more Americans covered and stopped insurance companies from denying coverage to people with pre-existing conditions. But it has also helped drive up premiums by adding coverage requirements. The result: Employers and individuals trying to cut premiums often shift to plans with higher out-of-pocket costs. (Helms, 6/1)

Nonprofit insurance plans designed to be an alternative for consumers under the 2010 health care overhaul generally succeeded in offering lower rates last year, but a majority of them struggled to meet enrollment projections, according to a new Government Accountability Office report. The average premiums for consumer operated and oriented plan, or CO-OP, programs – which are consumer governed, nonprofit health plans – were lower than premiums for other issuers in more than half of the rating areas in the 22 states where CO-OPs participated in the health insurance exchange during 2014, a GAO report said Monday. (Zanona, 6/1)

Dr. Cara Jakob has worked in all types of practice models: she has been part of a large group, she has been employed by a health system, and now she's an independent physician in a small practice in Clermont. Jakob has also been part of practice model that's starting to gain traction, an Accountable Care Organization, first with a group called Primary Partners and now with Aledade Central Florida ACO. (Miller, 6/1)

Myra Kodner has spent most of her career helping people qualify for programs such as food stamps and Social Security benefits. She knows qualifying people for a government program means submitting the right information in the correct format. So when her husband, Don, lost his job in customer service - and with it the couple's health insurance - in March 2014, Kodner swung into work mode. She gathered the couple's information and called the Affordable Care Act's healthcare.gov help line to buy insurance. ... But when the couple filed their 2014 income taxes, they were shocked to discover they did not qualify for a subsidy - and owed the government $8,000. (Calandra, 6/1)