There has been a lot of speculation, including by me, about what the Republican-controlled Congress will do should the Supreme Court rule against Obama in King v. Burwell. Should the Court strike down federal subsidies, Republicans will need to have a plan in place to address this decision as it impacts those who are currently receiving subsidies for ObamaCare from the federal exchange because their state did not set up a state exchange.
Republicans are still talking about a “fix” but are now stressing that it is to be “transitional” rather than permanent. According to Bloomberg:
[Representative Dennis Ross of Florida] added, “There’s a strong consensus in that room” that the subsidies must be continued in some form “until Republicans can substantively change the law.”
Participants at Wednesday’s closed-door meeting said key aspects of a transition plan were presented to lawmakers by Ryan, Energy and Commerce Committee Chairman Fred Upton, Budget Committee Chairman Tom Price of Georgia and Education and Workforce Committee Chairman John Kline of Minnesota.
Along with immediate repeal of the law’s individual and employer mandates, the plan would give states the option to build their own insurance exchanges and offer subsidies, using federal money.
Alternatively, people in states affected by the ruling would receive a subsidy to purchase an insurance plan either from healthcare.gov or on the open market.
The plan was “very well thought out” and satisfied conservatives, said Representative Bill Flores, a Texas Republican who is chairman of the Republican Study Committee, a caucus of about 170 conservatives.
The House plan, according to The National Journal, would:
- Continue the Affordable Care Act’s subsidies through the end of 2015, absent a Court stay of its decision that did the same.
- Immediately repeal the individual and employer mandates.
- Starting in 2016, states would be allowed to opt out of the law and its other various regulations. States would receive a block grant, the same amount as the subsidies that their residents would receive, to implement their own health care plans.
- In states that don’t opt out, individuals would continue to receive subsidies but could use them to purchase plans on and off of the ACA exchanges.
- The plan would sunset in 2017, compelling a new Congress and president to come up with a comprehensive Obamacare replacement.
House Democrats reject the repeal of the individual and employer mandates, and the White House is opposed to anything more than a “one sentence bill that authorizes the subsidies in every state.”
According to Politico, the Senate does not yet have a single plan:
GOP senators have discussed several proposals behind closed doors but are nowhere near consensus. After vowing for years to scrap the law and replace it, the party is rife with tension over what it would do if the onus was suddenly on it to come up with an alternative. Even if Republicans could settle on a legislative response, President Barack Obama would almost certainly veto it.
With a ruling expected this month, McConnell has signaled his preference by signing on to Johnson’s plan. McConnell also has signaled an interest in a separate approach by freshman Sen. Ben Sasse, a conservative from Nebraska who has proposed offering financial assistance through tax credits over 18 months but reducing them gradually over that time period.
Presidential hopefuls Rand Paul and Ted Cruz oppose fixes, however temporary. Politico continues:
“I would like to legalize inexpensive insurance policies, give more choice, let people choose their doctor, expand health savings accounts, help people save for their insurance,” Paul said. Asked if his plan would involve extending the subsidies, the Kentucky Republican replied: “A better way would be to try to legalize inexpensive insurance policies. … The president has made it illegal to buy inexpensive insurance in our country.”In a separate interview last week, Cruz said a victory for his side in the court case would be a “real opportunity for Congress to lead.”
He added: “In a perfect world, we would take that opportunity to repeal Obamacare. At a minimum, we should allow states to opt out.”
Cruz has his own Plan B: Scuttle the entire health care law, though he would allow for a six-month transition period in order to let the markets and states adjust to a full-scale repeal.
The Supreme Court decision is expected in the coming weeks, and it looks like Republicans plan to adopt a fix that will stand until Obama leaves office. What comes after that will depend on who wins the White House in 2016.DONATE
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