GOP’s health quandary

Republicans have been talking about repealing President Obama’s healthcare law for more than two years.

 By the end of this month, the Supreme Court might do it for them. 

 Should the justices deem “ObamaCare” unconstitutional, there will be widespread celebration in GOP circles. But the hangover afterward could be painful. 

 All Republicans in Congress are united on repealing the law, but they’re split over the other half of their promise: to replace it.

 In January of last year, the House passed a repeal bill, and GOP leaders said at the time that relevant committees would craft replacement legislation. 

 Nearly 18 months later, there is talk of medical liability reform and expanding health savings accounts, but there is no bill.

 Republican leaders have indicated that their replacement measure will contain ideas in the current law, such as allowing young adults to remain covered by their parents’ insurance. They have also mentioned covering pre-existing conditions. 

 They are adamant, however, that the entire law must be scrapped first.

 At a press conference last month, Speaker John Boehner (R-Ohio) said anything short of a full repeal “is unacceptable.”

 Last week Boehner would not say whether Republicans planned to take swift action to help people who could suffer if the law is suddenly overturned; he said his party would not rush to a remedy.

 Republicans better come up with a plan, because time is running short. If the law is tossed out, the GOP will find itself needing to put out several fires.

 Would the GOP look, for example, to close the so-called doughnut hole in Medicare prescription drug coverage, which is due to open up again if Obama’s reforms vaporize? The law minimized the hole, which is a popular outcome among seniors, a key voting bloc.

 Republican lawmakers have said in recent days that the drug industry should abide by the deal it struck with Washington on the reform law, regardless of how the court rules. But the House GOP’s own repeal bill states that all policies should be amended “as if [healthcare reform] had not been enacted.” Why should the drug companies feel obliged to stick to their side of an agreement if Washington (via the high court) reneges on its side?

 Another politically thorny issue is the $500 billion in Medicare cuts that were included in the law. Will Republicans, who have repeatedly criticized those cuts, now call for similar reductions so they don’t lose their credentials as fiscal hawks?

 Even if the law is upheld, Republicans — most notably Mitt Romney — will be pressed on these matters. Voters, after all, demand clarity as they assess their election-year choices.