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Obamacare Ruling Saves GOP from Tough Political Choices

By Melissa Attias, CQ Roll Call

June 25, 2015 -- The Supreme Court ruling that the health law's subsidies should be available in all 50 states regardless of whether they set up their own insurance exchanges deprives Republicans of a prime opportunity to take swipes at the overhaul ahead of the 2016 presidential election. But it also saves them from the precarious political situation that they would have faced if the justices sided with the plaintiffs in King v. Burwell, prompting an estimated 6.4 million people in 34 states to lose their financial help.

While Republican leaders in both chambers have spent the past few months discussing contingency plans, it was unclear whether a caucus so anxious to scrap President Barack Obama's signature health care law (PL 111-148, PL 111-152) would have been able to rally around any solution that could be seen as prolonging it. The high court's recent decision allows GOP lawmakers to keep their focus on repeal without having to juggle the blame game that would have taken hold if the subsidies lapsed.

"The politicians who forced Obamacare on the American people now have a choice: crow about Obamacare's latest wobble towards the edge, or work with us to address the ongoing negative impact of a 2,000-page law that continues to make life miserable for too many of the same people it purported to help," Senate Majority Leader Mitch McConnell of Kentucky said in remarks for the floor.

Democrats, meanwhile, celebrated the decision as yet another validation of the overhaul after the high court in June 2012 upheld the requirement that most individuals maintain health coverage or pay a penalty. The ruling makes it unlikely that significant changes will be made to the overhaul before the 2016 elections, preserving the status quo for the remainder of the Obama White House.

"Today, for the second time, the Supreme Court has upheld the Affordable Care Act," House Minority Leader Nancy Pelosi of California said in a statement. "This is a victory for common sense and for all American families. It is long past time for Republicans to abandon their assault on the newfound health security that the Affordable Care Act is providing millions and millions of Americans across the country."

The Democratic Senatorial Campaign Committee quickly sent out a fundraising email cheering the decision. 

The decision will also come as a relief to hospitals and the insurance industry, which submitted friend-of-the-court briefs in support of the Obama administration's position. If the subsidies lapsed, the concern was healthier people would have stopped paying for coverage, skewing the risk pool toward the old and sick and raising premiums. Hospitals stocks, and shares of all health companies, surged after the ruling, reflecting investor relief that providers won't be at risk of taking a financial hit with the loss of newly-insured patients.

In addition, the ruling preserves the pillars of the law that the supporters of the lawsuit said would have given way in federal exchange states. The challengers said that the absence of subsidies would have exempted many people from the mandate that they purchase coverage or face penalties because buying insurance would have been a financial hardship. And they maintained that businesses would have no longer had to comply with the mandate that they provide coverage of pay penalties because that requirement is linked to the availability of subsidies.

House Ways and Means Health Care Subcommittee Chairman Kevin Brady, R-Tex., said the ruling would speed up, rather than slow down GOP attempts to use budget reconciliation rules to repeal the law.

"It is accelerated now because of the ruling. I think we will move sooner rather than later. It's now clear reconciliation won't be used to free individuals and states from the law. It will be used to put full repeal on the president's desk," Brady said.

At a press conference following the decision, Speaker John A. Boehner, R-Ohio, said Republicans haven't made a decision on how to use the reconciliation process. He also wouldn't commit to having a House vote this year on a GOP alternative to the health law, noting that while the issue has been discussed, most of the focus was on what to do if the Obama administration lost in King v. Burwell.

If the court has sided with the plaintiffs, Boehner said House Republicans were prepared to move forward with a proposal and praised bicameral work on finding a unified response. "Now it's not necessary," he said.

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