Hundreds of thousands of Ohioans became eligible under the Patient Protection and Affordable Care Act to access federal subsidies for private healthcare company premiums, but they could find those high-cost premium teeth biting into them again if the U.S. Supreme Court rules later this year that states like Ohio, which let the federal government run its healthcare marketplace, can no longer participate.

Burwell v King, the case the high court will hear March 4, would only allow the 13 states who set up their own healthcare care to continue to enjoy continued relief from ever-rising private healthcare policies. When OhioNewsBureau asked new House Speaker Clifford Rosenberger recently what the state would do if the court rules against Ohioans who purchased insurance through the exchange instead of through their employer or on their own.  He said he wasn’t concerned about what might happen in the future. Qualifying his comment that the present is what he and his Majority Caucus will focus on, Speaker Rosenberger said “I’m not a judge,” as he side-stepped the question.

A more responsible decision that does peer into the future came Tuesday from two Ohio Democratic lawmakers who introduced legislation establishing an Ohio Health Care Exchange. Reps. Michael Stinziano (D-Columbus) and Nickie Antonio (D-Lakewood) said in a media release Tuesday that they will introduce a bill to protect Ohioans who have signed up or might do so in the future.

Michael Stinziano, the Ranking Democrat on the House Judiciary Committee, said in prepared remarks, “Now that the deadline for signing up for health insurance through the federally run marketplace has passed, it’s time for lawmakers in Ohio to prepare for a decision by the United States Supreme Court that potentially threatens the health care that hundreds of thousands of Ohioans receive.” Anticipating a close vote, Mr. Stinziano, who won his Columbus seat again last November, said Ohio should not ignore the potentially devastating financial consequences for many Ohioans if the Supreme Court rules that they are no longer eligible for federal assistance in paying their health insurance premiums.

Federal premium subsidies are available to uninsured individuals with incomes up to 400% of the federal poverty level, which is $47,080 for a family of one and $97,000 for a family of four in 2015. Individuals eligible for these subsidies paid, on average, just $105 a month for coverage purchased through federal health insurance exchanges, information supplied by Stinziano’s office said. Based on a recently released U.S. Department of Health and Human Services report, the average monthly premium would have been $374 without subsidies provided through the ACA.

“It’s time to consider again whether Ohioans wouldn’t be better served by a state run health care exchange,” Rep. Stinziano, who also serves on the House Insurance Committee, said today. It’s significant that 84 percent of Ohio consumers who have qualified for assistance have received an average of $247 in tax credits per month to help pay for coverage. As of February 6, more than 208,000 Ohioans had signed up for health care coverage through the federal exchange.

Mr. Stinziano was a co-sponsor of similar legislation (HB 412) which was sponsored by Rep. Antonio and former Rep. John Patrick Carney (D-Columbus) in the 129th General Assembly. “No one should underestimate the difficulty of establishing a state run exchange and moving so many Ohioans from the federal exchange to a state-run exchange, but, if the Supreme Court rules against the legality oft paying federal subsidies to policyholders enrolled through the federal exchange, we may have no choice but to act,” he said in his statement today.

His bill would make certain that, no matter what the Supreme Court decides in Burwell, Ohioans who are eligible to receive subsidies under the ACA [Obamacare], will continue to receive assistance.

While the bill makes great sense and represents a pro-active strategy rather than one that’s reactive, the bill’s authors are two of only 34 Democrats in the House, a minority that has no ability to alter whatever the 65 Republicans decided to do on any given issue on any given day.

Nicholas Bagley, a professor at the University of Michigan Law School, said without assistance from the federal government, many young and healthy enrollees “are simply going to drop” their health plans, while the sickest people would remain in the market,” according to Kaiser Health News. Bagley believes the court could expose insurers to greater risk if they side against the federal government, by causing them to hike their rates for all customers, not just those who entered the system through Obamacare plans.

In King v. Burwell, Plaintiffs argue that the Patient Protection and Affordable Care Act only permits premium subsidies in states that have set up exchanges. Regulations issued by the IRS in 2012 authorized the subsidies in both federal and state exchanges.

The Secretary of Health and Human Services, Sylvia Burwell, briefed the President about the end of this year’s Open Enrollment period for the ACA, telling him that 11.4 million Americans have signed up or re-enrolled for quality, affordable health insurance.