Republican lawmakers have floated a number of contingency plans in case the Supreme Court strikes down the Affordable Care Act’s financial subsidies for qualified individuals buying health insurance through the federal exchanges operating in 34 states.
The high court is expected to rule later this month in the case of King v. Burwell. While the case has been pending, several contingency proposals have been formally introduced as legislation or outlined in the press.
According to consulting firm Mercer, GOP leaders could use a budget process known as reconciliation, which would require only 51 votes in the Senate, to pass a King fix if the Supreme Court invalidates the subsidies.
The “Preserving Choice and Freedom in Health Care Act” (S 1016) appears to be the leading Senate fix, with 31 co-sponsors, Mercer says. The measure would allow individuals keep any health-care plan and subsidy they now have until August 2017 and would repeal the ACA’s individual and employer mandates.
In the House, meanwhile, the GOP chairmen of the Ways and Means, Education and the Workforce, and Energy and Commerce committees have proposed offering an in-advance, age-adjusted tax credit to individuals who lose ACA subsidies. They would also allow states to opt out of the ACA and into a Republican alternative system that repeals the law’s mandates but keeps some of its consumer-friendly provisions.
The “Winding Down Obamacare Act” (S 673), authored by Sen. Ben Sasse of Nebraska, would allow individuals to receive a “COBRA-like” continuation of subsidies for 18 months after the Supreme Court ruling, as would the “Patient Freedom Act” of Sen. Bill Cassidy of Louisiana.
As Mercer notes, it’s unclear whether and when Republicans will rally around a particular proposal. And, of course, the Supreme Court could make all of the GOP efforts moot by upholding the subsidies.