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Pro-ACA protestors. Photo: Erik McGregor/Pacific Press/LightRocket via Getty Images

States are beginning to make contingency plans in case the courts strike down the Affordable Care Act, WSJ reports.

Yes, but: There's only so much they can do.

Where it stands: As we all wait for the 5th Circuit Court of Appeals to hand down its ruling, and then for the likely appeal to the Supreme Court...

  • Colorado is looking to its state-level public option, still under formation, as an ACA fallback.
  • Nevada has formed a commission to look for ideas.
  • Louisiana is working on a plan to establish a high-risk pool for sick people.

The catch: Even setting aside the fact that this is only a small handful of states, even the most motivated blue state probably couldn't make up for the total loss of the ACA.

  • They could not deliver themselves a federally funded Medicaid expansion, for starters, and would have to raise an awful lot of revenue to replace the premium subsidies on the ACA's exchanges.
  • States would face their own drawn-out political battles if they wanted to re-impose the ACA's protections for pre-existing conditions and the accompanying rules that give the coverage mandate teeth.

And that's just the ACA's coverage expansion: States definitely couldn't fill the ACA's shoes on Medicare policy, biosimilars approval or the host of other programs that would fall by the wayside if the law is ultimately struck down.

Go Deeper: 10 states to experiment with wellness programs in their ACA markets

Go deeper

Updated 2 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: Coronavirus variant surveillance varies widely by state — Omicron cases confirmed in 5 U.S. states America probably won't lead the effort to understand Omicron.
  2. Vaccines: Omicron adds urgency to vaccinating world — Omicron fuels the case for COVID boosters — Moderna loses patent battles tied to COVID vaccine.
  3. Politics: Nevada to impose insurance surcharge on unvaccinated state workers — New Jersey GOP lawmakers defy statehouse COVID policy — Oklahoma sues Biden administration over Pentagon vaccine mandate — Omicron travel bans are sign of what's to come.
  4. World: WHO: Delta health measures help fight Omicron — COVID cases surge in South Africa in sign Omicron wave is coming — Germany approves new restrictions for unvaccinated people.
  5. Variant tracker: Where different strains are spreading.

Prosecutors charge parents of Michigan school shooting suspect

Photo: Scott Olson/Getty Images

The parents of a 15-year-old accused of killing four students and wounding seven other people at a Michigan high school have been charged with involuntary manslaughter, according to court documents.

Driving the news: James and Jennifer Crumbley were each charged with four counts of involuntary manslaughter.

2 hours ago - World

Putin to demand legal guarantee against NATO expansion in call with Biden

Biden and Putin meeting in Geneva in June. Photo: Mikhail Metzel\TASS via Getty Images

Russian President Vladimir Putin is demanding a legally binding guarantee that NATO will not expand east — including to Ukraine — and plans to raise the issue in an upcoming phone call with President Biden, according to the Kremlin.

Why it matters: Russia has massed more than 94,000 troops on the border with Ukraine and could be preparing for a large-scale invasion at the end of January, Ukraine's defense minister said Friday.