Ryan, health chief clash over ObamaCare plans

House Ways and Means Chairman Paul RyanPaul RyanHave Republicans hit rock bottom on voting rights yet? Biden should have been the clear choice for vice president Trump, Clinton intelligence briefings likely to start next week MORE (R-Wis.) clashed with President Obama's healthcare chief at a hearing Wednesday over preparations for a looming Supreme Court decision on ObamaCare. 

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The case of King v. Burwell could invalidate subsidies for 6.4 million people in 34 states using the federal marketplace under the law. Ryan, the leading House Republican planning for the decision in King v. Burwell, pressed Health and Human Services (HHS) Secretary Sylvia Mathews Burwell on whether Obama will seek a one-sentence fix to restore the subsidies.

"The question is what will the administration do: will they stand up with one piece of paper and say 'my way or the highway' or will he work with Congress?" Ryan said.

Obama had pointed to the one-sentence fix to the law's text at a press conference this week.

Burwell countered that there is not much the Obama administration can do at the moment, though she did refer to some planning efforts where previously the White House had given none. 

"We’ll do everything we can, we’re working to make sure we are ready to communicate to the states and do everything we can," Burwell said. 

Burwell raised the prospect last week, at a Wall Street Journal breakfast, that states could receive help from HHS in setting up their own exchanges, allowing subsidies to continue. 

But that solution would require state leaders to agree to work with HHS, which many Republican governors are reluctant to do. 

"The critical decisions will sit with the Congress and states and governors to determine if those subsidies are available," Burwell said. 

Burwell also rejected a leading Republican plan from Sen. Ron JohnsonRon JohnsonSanders could be secret weapon for Dems The Trail 2016: The newrevolution begins Greens launch M ad buy in Wis. Senate race MORE (R-Wis.) that would extend ObamaCare subsidies until 2017, but would also repeal the law's individual and employer mandates. 

“This bill in its current form is repeal,” Burwell said of the bill. “And the president has said he will not sign something that repeals the act.”

The hearing was supposed to be about the HHS budget, but Ryan nixed that topic, citing Obama's speech on Tuesday strongly defending ObamaCare.

"It shouldn’t surprise you that we’re more interested in talking about ObamaCare, especially given the president’s remarks this week," Ryan said. "Whatever the Supreme Court decides later this month, I think the lesson is absolutely clear: ObamaCare is flat busted."

The top Democrat, Rep. Sandy Levin (Mich.), hit back at Ryan.

"What's busted is not the ACA, but your attacks," he said. "Endless attacks, never coming up with a single comprehensive alternative all these years, so you are armchair critics while millions have insurance who never had it before."

He also pointed out that Republicans are backing the King v. Burwell lawsuit. 

"It’s your allies who brought the suit that will deprive them of insurance," Levin said. 

Ryan pressed Burwell on whether the administration would work on an overhaul of ObamaCare to promote “freedom.” Burwell responded that under ObamaCare already, “the marketplace is a market. It uses private insurers.”

Rep. Kevin BradyKevin BradyFroman: Too early to start trade talks with the UK Advisers: Trump's revised tax plan will resemble Ryan's Overnight Healthcare: Health mergers in trouble? | Norovirus in Cleveland | GOP chairman rejects Trump Medicare pricing plan MORE (R-Texas) also pressed Burwell on what kind of fix Obama would sign if the Supreme Court rules for the plaintiffs.

He repeatedly asked if a one-sentence fix restoring the subsidies is the only bill Obama would sign.

Burwell repeatedly declined to give a straight answer, eventually saying she could not give a reply on “hypothetical” legislation.

“We will review any legislation we get,” she said.

Burwell also told Ryan, “we believe there are improvements that can be made” to the law, but indicated that drastic changes that repeal major elements of the law would be rejected.

Senate Majority Leader Mitch McConnellMitch McConnellProgressive group changes tone on Kaine Trump hits Kaine on TPP: He supports a 'job killer' Clinton maps out first 100 days MORE (R-Ky.) told "The Hugh Hewitt Show" last week that he thinks Obama will veto any Republican plan in response to the court case anyway.

“What I think he’ll probably do is veto anything we send him and put the pressure on the states to cave and turn established state exchanges in place of federal exchanges, thereby making them eligible  for subsidies,” McConnell said.