The GOP’s secret plan to fix PPACA
(Bloomberg Politics) — Congressional Republican leaders say they have a fallback plan ready to go if the Supreme Court cripples a core component of the Patient Protection and Affordable Care Act of 2010 (PPACA) this month.
But the details of the plan are being kept secret.
“We’ll have a plan that makes sense for the American people,” Senate Majority Leader Mitch McConnell said Monday in a radio interview with The Joe Elliott Show.
But what’s in the plan?
“We’ll let you know depending on the outcome of the decision,” the Kentucky Republican said, referring to the case King vs. Burwell, which is expected to be decided this month.
Bloomberg tried to get answers Tuesday from the senior Republicans who work on health policy. Their fallback plan might interest millions of Americans who stand to lose their insurance subsidies, as well as the insurance industry, which would likely lose many customers and be compelled raise premiums. Details to come, the planners say.
“Yeah, we are” ready to act, Tennessee Sen. Lamar Alexander, the chair of the Health, Education, Labor and Pensions Committee, said in an interview. But what will the action be? “We’ll let you know if we have to do it,” he said.
Senate Republican Conference Chair John Thune of South Dakota said that if the Supreme Court “give[s] us seven months to fix this, we’d love the opportunity to try to come up with a better alternative.”
Wyoming Sen. John Barrasso, the leader of the efforts to write a Republican alternative, also didn’t discuss details of the fallback plan. “We’ll bring that out after the Supreme Court makes a ruling,” he told reporters.
Rep. Paul Ryan, the chairman of the Ways and Means Committee, told Bloomberg that his party “will have a Republican alternative to deal with this,” but also wouldn’t offer any specifics.
Republicans have struggled since passage of PPACA to unify behind alternatives, even as they continue to call for “repeal and replace.” It’s not yet clear Republican leaders have the support to pass a bill to mitigate the chaos that experts say will occur if the Supreme Court voids the federal exchange subsidies. Conservatives familiar with the matter say privately that Republican leaders want to convey to the Supreme Court, particularly Chief Justice John Roberts, that they’ll be ready to act if the ruling goes their way.
A bill offered by Wisconsin Sen. Ron Johnson has garnered 32 Senate Republican supporters. It would extend the subsidies through August 2017 and repeal the law’s individual and employer mandates. But even a temporary extension of Obamacare subsidies faces conservative skepticism, particularly in the House. And repeal of the mandates wouldn’t fly with the White House, Health and Human Services Secretary Sylvia Mathews Burwell said Wednesday at a House hearing. Other Republican health care proposals have less support.
One idea Republicans have rejected is to simply tweak the law to clarify that PPACA premium subsidies are available in all 50 states. At issue in the case is whether the language in the statute forbids Americans in two-thirds of states who are enrolled through the federal HealthCare.gov exchange system from accessing the subsidies, which are designed to make coverage affordable for lower-income people.
Democrats said they don’t know of a Republican plan.
“We have no idea what they’re talking about. It might be a secret, or it might not exist,” said Adam Jentleson, a spokesman for Senate Minority Leader Harry Reid, a Nevada Democrat. “All I know is that smart Republicans know that the ruling they’re publicly rooting for would be a disaster for them.”