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State Republican leaders are ratcheting up the pressure on Congress to overhaul the Affordable Care Act if the Supreme Court this month rules that subsidies on the federal exchange are invalid. Republicans from 33 states have written to Congress as part of a coordinated message urging federal legislators to develop a plan that would free states from the pressure of setting up their own exchanges to salvage subsidies, according to the Foundation for Government Accountability, a conservative think tank. (Armour, 6/19)

As the Supreme Court prepares to rule on whether to block health insurance subsidies in 34 states that use the federal insurance exchange, Pennsylvania and Delaware are the best prepared. They have submitted detailed plans for creating their own exchanges by next year, a move intended to keep subsidies flowing to their residents, though possibly with an interruption. (Goodnough, 6/21)

Days before the Supreme Court could strip it of a central component, there is still no "plan B" for Obamacare. Health and Human Services Secretary Sylvia Burwell warned the Obama administration will be unable to cover the millions of Americans who could lose their medical insurance if the Supreme Court decides to unravel much of the Affordable Care Act. (Acosta, 6/21)

Experts say the proposals floated by Republicans in response to the looming Supreme Court ruling on ObamaCare could lead to higher premiums, but also create improvements in the healthcare system over time. Congressional Republicans have for weeks been debating what they will do if the Supreme Court rules against the Obama administration in King v. Burwell. A defeat for the law could strip insurance subsidies from 6.4 million people. (Sullivan, 6/20)