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A pending U.S. Supreme Court case could increase health care costs for tens of thousands of Wyoming residents.

The nation’s top court is expected to issue a ruling in the early summer on the closely watched King v. Burwell case.

The lawsuit is challenging a key part of the Affordable Care Act that allows customers buying health insurance through the federal exchange to receive subsidies.

Supporters of the challenge say the law only allows state-run exchanges to offer these benefits.

Wyoming is one of 34 states that use the federal exchange and could be affected by the ruling.

According to an analysis using 2016 projections by the Washington-based Urban Institute, 40,000 Wyoming residents would lose their subsidies at an average loss of $5,350 per person if the court rules in favor of the plaintiffs.

This would affect low- and moderate-income residents who receive tax credits that lower their monthly premiums. It would impact those who receive cost-sharing reductions, which provide discounts on their out-of-pocket deductibles, co-insurance and co-payments.

Tracy Brosius is the operations director for the Wyoming Institute for Population Health, which sponsors one of the federally funded initiatives that seeks to help Wyomingites enroll through the federal exchange.

She said losing the subsidies would leave many uninsured, since they would no longer be able to afford the insurance.

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“For our consumers, I am concerned because we have seen so many fabulous stories of people finally being able to get insurance,” Brosius said.

Several prominent conservatives, such as Louisiana Gov. Bobby Jindal, are advocating for the court to overturn the provision, since doing so could unravel the entire Affordable Care Act.

They say this will give Republicans a chance to fix or replace the law.

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But Gov. Matt Mead said during a news conference last week that even though he thinks the Affordable Care Act is bad policy, he hopes the court will reject the case and uphold the law.

“If on June 30, if that’s when the case comes down, and they say no more subsidies for federal exchanges … it is going to cause a lot of turmoil,” Mead said. “Not just for the state, and for those people, but for the private sector as well.”

But Mead said there is little Wyoming could do if the court rules the subsidies can’t be offered through the federal exchange.

Because of Wyoming’s small population, he said setting up a state-run exchange in a short period of time is unrealistic. And he said using state funds to help those who lose their subsidies is not a feasible option.

“We will see what the decision is, and if the Supreme Court upholds the federal government’s position, that is one thing,” he said. “If they don’t, I think we will be one of many, many states that will be scrambling, trying find an answer and seeing whether Congress can provide the statutory fix that would be needed.”

The Supreme Court heard oral arguments in the case earlier this month. It is expected to issue its ruling when its term comes to an end in late June or early July.

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