Politico reported last night that Republicans were making contingency plans in advance of the Supreme Court’s ruling on Obamacare. Some conservatives were alarmed by the story, but as far as I can tell they shouldn’t have been.
Said Politico: “If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines.” My own understanding, based both on talking to sources familiar with the House leadership’s thinking and just observing how they’ve handled health care for months, is that if Obamacare is upheld they will continue doing what they’ve already been doing. They’ll hold another vote on repealing the whole thing, to make it clear that neither the passage of time nor the Court’s upholding of the law has altered their opposition; they’ll hold votes on getting rid of particularly vulnerable provisions of the law; and they’ll pledge to repeal and replace the law if they get a president and Senate willing to cooperate.
More Politico: “If the law is partially or fully overturned they’ll draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions. Ripping these provisions from law is too politically risky, Republicans say.” My own understanding is closer to what Avik Roy writes at Forbes: “Republican policymakers are trying to pre-emptively address the legitimate policy issues that arise if Obamacare is overturned by the High Court. For example: those young adults who are currently on their parents’ insurance plans—if Obamacare is struck down, are those plans voided, or do they continue until the end of the contract year? The 50,000-or-so people who’ve enrolled in the law’s high-risk pools—what can be done to ensure that they maintain their coverage?”
There was widespread confusion in the press about the House Republicans’ position on pre-existing conditions when they released their “Pledge to America” in advance of the 2010 elections. They had stated that they favored the pre-Obamacare law that required insurers to cover people with pre-existing conditions if they already had coverage. Some reporters confused this for the Obamacare provision that requires insurers to cover people with pre-existing conditions regardless of their prior coverage status: a provision that would make it possible for people to wait until they’re sick to get insurance, thus requiring some additional intervention such as an individual mandate to make insurance markets feasible. I wonder if a similar confusion is at work in last night’s story.
In any case, Speaker Boehner has now reiterated that he remains committed to full repeal. Good.
P.S. I wrote a few months ago about why the Republicans haven’t unified behind a specific plan to replace Obamacare, and how they could overcome their division.