Healthcare

ObamaCare subsidies question splinters GOP

About one month before the Supreme Court’s ruling on ObamaCare subsidies, Republican lawmakers are all over the map about what to do about the millions of people who could lose them.

Republicans have widely agreed they need a plan if the high court strikes down a subsidies next month. But the GOP does not agree about how to help people who’d lose access to healthcare — and even whether to help them at all.

{mosads}There are more than half a dozen plans floating around, with varying degrees of details.  While many lawmakers have said there is a “great deal of consensus” within the party, some of the proposals are sharply different from each other.

“There is one view that Congress can leave the subsidies in place for a short period of time until there are alternative solutions available,” Rep. Bill Flores (R-Texas), chair of the conservative Republican Study Committee, said in a recent interview.

“There’s another view that says, ‘Look, this problem was created by the way the Democrats wrote the law. Why should Republicans suddenly wind up with ownership over that problem?’”

The stakes are high: A ruling against the healthcare law could strip federal aid from an estimated 7.5 million people ahead of the 2016 elections, and people in red states would be hit particularly hard.

Leading proposals

Sen. Ron Johnson (R-Wis.): Introduced a bill to let people keep their ObamaCare subsidies until 2017, when he hopes a Republican president will be in office. The plan also repeals ObamaCare’s individual and employer mandates.

Sen. Ben Sasse (R-Neb.): Introduced a bill to create a new system of tax credits. Sasse has sharply contrasted his plan with Johnson’s and said he opposes extending ObamaCare subsidies because he doesn’t support doing “anything to fix ObamaCare in Congress.”

Reps. Paul Ryan (R-Wis.), Fred Upton (R-Mich.) and John Kline (R-Minn.): The plan put forth by the trio of chairmen serving as leaders of the House’s working group provides a “refundable,” “advanceable,” age-adjusted tax credit, while allowing states to opt-out of ObamaCare’s mandates, according to an op-ed from March. They have so far declined to provide details on the tax credits, such as how they would be paid for.

Sens. John Barrasso (R-Wyo.), Orrin Hatch (R-Utah), and Lamar Alexander (R-Tenn.):  The leaders of the Senate’s working group have endorsed “transitional” financial assistance, but have not said whether it will be an extension of ObamaCare subsidies. “I think you can define it how you want, but we want to make sure those people are protected as we transition away from the healthcare law,” Barrasso said.

Sen. Richard Burr (R-N.C.), Hatch, Upton: Introduced an ObamaCare replacement plan that would create “targeted tax credits” based on age and family size to help people buy private insurance or fund a health savings account. The plan does not specifically address the court’s ruling.

Presidential candidates:

Sen. Marco Rubio (R-Fla.): Has outlined his own plan in an op-ed. It includes tax credits and high risk-pools, as well as the controversial Paul Ryan-style idea of a voucher-like system for Medicare. He does not include a provision for temporary assistance.

Sen. Ted Cruz (R-Texas): Has also put forward his own plan, which would repeal ObamaCare’s subsidies and mandates, and allow people to buy insurance across state lines. He does not include a provision for temporary assistance. Spokesman Rick Tyler said Friday that Cruz will wait for the court’s decision to decide on the temporary assistance.

Sen. Rand Paul (R-Ky.): Has not taken a position on a back-up plan or temporary assistance. Spokeswoman Jillian Lane on Friday declined to comment but said, “I’m sure the Senator will weigh in on this issue in the near future.”

Other key lawmakers:

Rep. Tom Price: Against continuing subsidies, but has put forward a full alternative including tax credits and high-risk pools. “I don’t think that I would be able to be supportive of continuing the subsidies beyond what the court would allow,” he said.

Rep. Bill Flores (R-Texas): Working on a Republican Study Committee ObamaCare alternative. Flores is undecided on continuing subsidies. “I’m not saying there should absolutely not be a bridge, I’m not saying there should absolutely be a bridge.”

Sen. Bill Cassidy: Supports a temporary extension of ObamaCare subsidies until GOP can permanently replace the law. Cassiday has drafted a bill that maps out that permanent replacement, which he says would work in tandem with the GOP’s more immediate plan.

Leadership:

Senate Majority Leader Mitch McConnell: Supports competing plans from Johnson and Sasse, though his spokesman said the leader is still “reviewing other proposals.” His office declined to comment about his position on extending subsidies, saying, “No matter what the court does, Republicans will work to protect Americans harmed by ObamaCare’s broken promises.”

House Speaker John Boehner: Has said nothing about his preferred plans, deferring to working group members. A spokesperson declined to comment further on Friday.

Conservative groups:

Heritage Foundation, Americans for Prosperity and Club for Growth: Opposes any extension of ObamaCare.

Cato Institute: Opposes any extension of ObamaCare. Michael Cannon, one of the architects of the case known as King v. Burwell that is now before the court, said recently: “I actually think it’s a little silly for Republicans to try to put together a response [before the ruling.]”

Tags Bill Flores Boehner John Barrasso John Boehner Lamar Alexander Marco Rubio Mitch McConnell Orrin Hatch Patient Protection and Affordable Care Act Paul Ryan Rand Paul Richard Burr Ron Johnson Ted Cruz
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