Supreme Court Obamacare case poses political peril for GOP
The Supreme Court could be months away from blowing a huge hole in Obamacare â and Republicans on Capitol Hill are at odds over how theyâll respond if their side wins. Itâs the latest example in a long-running quandary for Republicans: They donât agree on what alternative, if any, their party should offer to President Barack Obamaâs signature health care law. But the issue is taking on new urgency for the GOP congressional leaders as the court takes up a case that could leave more than 5 million people without Obamacareâs crucial subsidies. Story Continued Below If they simply âfixâ Obamacare, theyâll anger their right wing that wants the party to focus solely on repealing the law. If they do nothing, they invite blame for making health care unaffordable for millions of Americans â including some of their own constituents. The case, King v. Burwell, will be argued before the Supreme Court on March 4. At issue is whether the precise language of the law requires that subsidies should be available to people in all states â or only in those that chose to run their own health insurance exchanges. Many Democratic-led states chose to set up exchanges; most GOP-led states, in a demonstration of their opposition, did not and let the federal government do so instead. Now, if the court were to rule against the administration, it would cut off the financial assistance to about 5 million lower- and middle-class people in the 37 states that did not set up their own exchanges. Most GOP-led states would be affected. House Speaker John Boehner and Senate Majority Leader Mitch McConnell have told their partyâs powerful committee chairmen to begin working on a roadmap for a Republican response if their side comes out victorious when the court rules, probably in late June. Sen. Lamar Alexander (R-Tenn.), who is meeting weekly about the health law with Sens. John Barrasso (R-Wyo.) and Orrin Hatch (R-Utah), wouldnât say if the GOP has ruled out new legislation to aid those who would lose the subsidies. âWeâve got a number of Republican senators who are talking,â said Alexander, who chairs the Senateâs Health, Education, Labor and Pensions Committee. âWe are talking with Reps. [Paul] Ryan and [Fred] Upton in the House. We want to be responsible about repairing any damage that Obamacare does. If it creates a shock to the system by causing 5 million Americans suddenly to put their insurance and their subsidies at risk, then we need to think if thereâs anything we need to do. Maybe thereâs not.â Some conservatives say the party should do everything in its power to kill the law if the Supreme Court rules their way. If Republicans in Congress try to preserve a crucial element of the law, conservatives say, it will be an all-out war within the GOP. âIf thatâs the indication, that we are going to give up on a core promise [to block Obamacare] â¦ thatâs exactly what upsets grass-roots conservatives â itâs saying one thing and doing another,â said Rep. Tim Huelskamp (R-Kansas). To channel that anger, the House plans to vote again on Tuesday on repealing Obamacare â and this time, a GOP-controlled Senate will likely take it up, as well, even though the Democrats have enough votes to block it through a filibuster. Some Republicans believe that having a plan â or the outlines of one â in place would send the Supreme Court the message that ruling against the White House wonât result in total chaos, particularly for those people who have already benefited from subsidies. If the court rules against the administration, low- and middle-income Americans would get little notice before the cost of their health insurance could increase by hundreds of dollars a month. âI donât think anybody wants to stop people from getting basic health care,â said Hatch, the powerful Finance Committee chairman. âBut if it is an opportunity to improve the Affordable Care Act, that opportunity should be seized.â Asked about the all-out push for a repeal, rather than simply fixing the law, Hatch said: âWhatever you do, the president is going to veto it. Thatâs a nice thing to say, but it doesnât necessarily mean that thatâs whatâs going to happen.â If the court rules against the White House, several Republicans said the powerful tool known as budget reconciliation should be used to push a new health care proposal â an attractive vehicle since it means that a replacement law need only achieve a simple majority in the Senate, even though Obama could still veto it. Still, there is ample debate within the GOP over whether reconciliation legislation should be used to take aim at small pieces of the law or whether to go for full-scale repeal. Don Stewart, a McConnell spokesman, said the Republicans would respect a ruling that the subsidies are illegal. If the Supreme Court finds that the Obama administration âhas been unlawfully implementing harmful mandates, Republicans will not work to reimpose those mandates.â Stewart added: âRemember, Republicans want to empower states and help Americans who have been hurt by Obamacareâs broken promises.â In the House, Majority Leader Kevin McCarthy announced Friday that Ways and Means Chairman Ryan, Energy and Commerce Chairman Upton, and Education and the Workforce Committee Chairman John Kline (R-Minn.) are leading a task force to figure out an Obamacare replacement plan. They will also examine how to respond to the Supreme Court ruling. So far, the three chairmen have met twice and staff members have met at least one additional time. Kline said that a lot of work on an Obamacare replacement plan was done in the last Congress. âSo weâre not starting with a blank piece of paper,â he said. âOn the other hand, weâre looking at this specifically at what to do as a result of that [Supreme Court] decision. Weâre a little early.â A ruling that eliminates the subsidies could have huge political implications in states that will be pivotal to Republican efforts to win the White House and maintain control of the Senate in 2016. Subsidies could be eliminated in Florida, Ohio, North Carolina, Pennsylvania and Wisconsin, to name a few â all are swing states in the 2016 presidential election with GOP-controlled Senate seats. With Obama and Democratic candidates pushing the issues of income inequality hard heading into next year, top Republicans say they need a robust response to the onslaught of attacks. Sen. Richard Burr (R-N.C.), who could face a tough reelection next year, said that the onus will be on the White House if the law is derailed by the Supreme Court. âAs far as Iâm concerned, if King v. Burwell is struck down, the White House is the one responsible to say what theyâre going to do next,â Burr said. âTheyâre the ones between a rock and a hard place because this is their plan.â The Justice Department has argued in its briefs to the court that a ruling against the administration would result in about 5 million people losing subsidies and immediately seeing higher insurance costs. That would lead to significant chaos in the state insurance markets, the administration said, which would likely be overrun by the most sick customers. The White House wonât talk publicly about any contingency plan of its own. Allied health care groups say they donât see a quick fix if the court strikes the subsidies. Alexander stressed that even if the court rules against the administration, states that did not establish an exchange would still have the option to reverse their decision. Doing so would allow the subsidies to go to their residents once again. Plus, it could relieve Republicans on Capitol Hill from voting to put Obamacare back together. âThere are 5 million people who could be affected by this, but everyone single one of them can keep the insurance and keep the subsidy if their state decides to create an exchange,â Alexander said. âWhat weâre talking about is if thereâs any additional action to take here.â Still, many states may decide against implementing their own exchanges. And even if they did, the process could take months or years to complete. Itâs extremely expensive and difficult, as a number of states whose exchanges failed learned last year. What Republicans on Capitol Hill would do in the interim remains an open question. âThis is what weâre talking about â probably every week â as to what the Republican response should be,â said Sen. Dean Heller, a Republican from the swing state of Nevada. âIâd vote tomorrow to repeal the law, donât get me wrong. But I also understand our limitations as a caucus with a sitting president and not having the votes necessary to override a veto. So you have to be pragmatic about this in your direction.â