Ready for another "what if the Supreme Court knocks out subsidies" study? This one, brought to us by HealthPocket, takes a look at what health insurance will really cost folks in the 37 federal exchange states if the high court eliminates the federal premium subsidy program.

The court is due to hear arguments in King v. Burwell in March. If it determines the subsidies are going away, here are the Top 5 states with the highest combined annual premium and deductible cost, based on the ever-popular bronze plan:

  1. Alaska

  2. Wyoming

  3. Delaware

  4. Wisconsin

  5. South Carolina

Those with the lowest will be:

  1. New Jersey

  2. Oregon

  3. South Dakota

  4. New Mexico

  5. Montana

As HealthPocket found, there's a huge gap between the costliest non-subsidized state, Alaska, and the least expensive, New Jersey: the Last Frontier State is 60 percent more expensive for consumers than what HealthPocket projects folks in the Garden State will pay.

When HealthPocket looked just at premiums, New Mexico had the lowest cost bronze plan premium, while New Jersey had the lowest average deductible for a bronze plan. The reason New Jersey ranks so low in these calculations is that it is the only state that caps deductibles (at $2,500.21). 

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If the subsidies are nixed, many may lose their insurance because they won't be able to pay. Sticker shock was outlined by HealthPocket in its report.

"The average subsidized premium for a federal exchange health insurance plan is $82. In comparison, an entry-level bronze plan costs a 40 year-old nonsmoker $294 a month without subsidies," HealthPocket said. On average, most with exchange insurance paid about 24 percent of the actual cost of their coverage.

"A migration to lower cost bronze plans could reduce some of the expense associated with subsidy loss but the premium increase would still be dramatic," said Kev Coleman, head of research & data at HealthPocket.

"These bronze plans have higher out-of-pocket costs than the typical exchange plan selection and cost-sharing reductions would no longer be available if subsidies are eliminated. With that said, it should be remembered that those consumers who don't qualify for subsidies already face these costs."

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.