Congressional Republicans acknowledged their options are limited in replacing Obamacare though they vowed that the U.S. 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.”
Republican presidential candidates, some of who serve in Congress, added their voices to calls to scrap the law, though they didn’t say how they’d do so.
The court in a 6-3 ruling Thursday upheld Obamacare’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 quickly move changes to the law through Congress. House Speaker John Boehner said that no decision has been made on whether to use that procedure.
Even if the Republican-led House and Senate were able to pass legislation repealing the health-care law, Obama would veto it and Democrats would provide enough votes to sustain a veto. The House has already voted more than 50 times to repeal all or part of Obamacare.
Thursday’s court ruling is a “very strong decision,” said Joseph Antos, a health policy expert at the American Enterprise Institute, a group that supports limited government.
“Because this is such a strong decision and endorsement of the Democrats’ stand on this, it makes it even less likely that Republicans could pass any kind of legislation changing anything about the Affordable Care Act,” Antos said.
Boehner said the Republican “struggle” against the health care law will continue. Yet he wouldn’t commit to any vote this year to replace the law or suggest how broad the Republican effort to change the law might be.
“My point is there’s been no decision” by Republicans on their next step, he said at a news conference Thursday after the court ruling.
Price, an orthopedic surgeon before being elected to Congress, said House Republicans will probably decide to use reconciliation to try to repeal Obamacare. “I think that’s where the conference will be,” he said.
Representative Paul Ryan, chairman of the House Ways and Means Committee, had been working on a plan in case the court ruled against the law. He said after Thursday’s decision 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 what some Republicans say are 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,” McConnell 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 budget maneuver that would limit Democrats’ ability to block a bill. It allows legislation to advance through the 100-member Senate with 51 votes, instead of 60.
The Senate Appropriations Committee Thursday approved a spending bill that would block the Department of Health and Human Services from spending funds to implement the law.
Attacking all of Obamacare’s regulations and parts through reconciliation would be complex. Obama said at the White House Thursday that the Affordable Care Act “is here to stay” and is providing health care to millions of Americans.
“What we’re not going to do is unravel what has been woven into the fabric of America,” the president said. “I can work with Republicans and Democrats to move forward. Let’s join together. Make health care in America even better.”
Democrats in Congress said the court 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, with a number of potential ways to pursue it.
Representative Matt Salmon of Arizona predicted that repeal will now become a common theme of Republican candidates. Several Republicans, including presidential candidate Senator Marco Rubio of Florida and Representative Pete Sessions of Texas, have bills ready or are working on bills to modify or replace the 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.
Sessions told reporters he would have a bill ready within days “that talks about the vision that Republicans could have.” He added, “We’ve got lots of members of Congress and it will be one of the options.”
Rick Santorum, a former U.S. senator from Pennsylvania, was among the 2016 White House contenders calling to change the law, although he offered few details.
“Today’s ruling by the Supreme Court is yet another reminder that if we are to rid our nation of Obamacare once and for all, we need to elect a conservative president prepared to lead on day one,” Santorum said. “As president, I will be committed to repealing the monstrosity of Obamacare and replacing it with a patient-centered program that puts people first, not the government.”