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Law says that HHS “shall” pay cost-sharing subsidies to insurers. Trump’s exec order can’t change the law 1/9 
Q ≠ *whether* fed govt will make payments but *when*. If Trump admin won’t pay, insurers can sue fed govt in Ct of Fed Claims—& will win 2/9
Congress’s failure to appropriate $$$ for cost-sharing is not a defense. Subsidies ultimately payable from fed Judgment Fund 3/9
Trump/Cong may try to freeze Judgment Fund payments, but these = debts of the US govt. Failure to pay would = debt default 4/9
It might not be until 2021, but ultimately, insurers are overwhelming likely to get their $$$. But what happens in meantime? 5/9
Insurers might go wobbly, w/draw from add’l mkts or hike premiums dramatically. Which is why states should step in 6/9
States should make cost-sharing payments themselves & then sue fed govt to recover (subrogation) 7/9
We’re talking abt ~$10 billion here across 50 states. That’s a lot for insurers, but most states can w/stand the blow temporarily 8/9
& it’s only temporary. Ultimately Judgment Day will come. 9/9
