WASHINGTON – Congressional Republicans acknowledged their options are limited in replacing President Barack Obama’s health insurance law though they vowed that the Supreme Court decision upholding federal subsidies is not the end of their fight.
“You deal with the rules that you have,” said House Budget Chairman Tom Price of Georgia. “And now, the rules won’t let you do everything you wanted to do.”
The court in a 6-3 ruling Thursday upheld the Affordable Care Act’s nationwide tax credits used by millions of Americans to buy insurance. The court said the Affordable Care Act allows tax credits in all 50 states, not just the 16 that have authorized online insurance exchanges.
It’s unclear whether Republicans will attempt to use a budget maneuver known as reconciliation, an option they have endorsed in the past, to move changes to the law through Congress quickly. House Speaker John Boehner said no decision had been made on whether to use that procedure.
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Price, who is a physician, said the House Republican conference will probably decide to use reconciliation to try to repeal the health law, also known as Obamacare.
“I think that’s where the conference will be,” he said.
Rep. Paul Ryan, chairman of the House Ways and Means Committee, had been working on a contingency plan in case the court ruled against the law. He said after the decision was announced that his committee “will continue its work to advance a patient-centered alternative to finally repeal and replace Obamacare.”
Senate Majority Leader Mitch McConnell, a Kentucky Republican, urged Democrats to work with Republicans to alter the law – which he called “a rolling disaster” – to mitigate its adverse impacts on the American public.
“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,” he said in a speech on the Senate floor shortly after the ruling was issued.
McConnell has in the past raised the possibility that Republicans could use reconciliation to undo the law. His spokesman Don Stewart didn’t immediately comment on whether McConnell would pursue that approach now.
Reconciliation is a procedural shortcut that would limit the opposition congressional Democrats could wage. It allows legislation to get through the Senate with only 51 votes, instead of 60.
But attacking all of the law’s regulations and parts through reconciliation would be complex. President Barack Obama – who said Thursday there is “no doubt” the law is working – could veto any bill that reaches his desk.
Democrats said the court’s ruling is a signal to Republicans to stop trying to change the law.
“Stop wasting the time of the American people by trying to repeal a law,” said Senate Minority Leader Harry Reid, a Nevada Democrat. “Enough’s enough. Let’s move on.”
Some Republicans insisted that legislative repeal is the next step, but reflected that there are a number of potential ways how to pursue it.
Rep. Matt Salmon of Arizona predicted that repeal will now become a common theme of Republican candidates. Several Republicans, including presidential candidate Sen. Marco Rubio of Florida and Rep. Pete Sessions of Texas, have bills ready or are working on bills to modify or replace the health law.
“I remain committed to repealing this bad law and replacing it with my consumer centered plan that puts patients and families back in control of their health care decisions. We need consumer care, not Obamacare,” Rubio said.
“I'll be ready to put my bill – a full bill that talks about the vision that Republicans could have – out in just a few days,” Sessions told reporters. He added, “We’ve got lots of members of Congress and it will be one of the options.”