POLITICS
01/30/2015 01:47 pm ET Updated Jan 30, 2015

GOP Senator's Answer On Fixing Obamacare: 'No, No, No, No'

ap

"No, no, no, no."

That's Sen. Dan Coats (R-Ind.) talking about whether Republicans in Congress would take quick action should the Supreme Court issue a ruling that forces millions of people to give up health coverage they've gotten through Obamacare.

This summer, the court is expected to rule in King v. Burwell, in which the plaintiffs allege the Affordable Care Act's language does not authorize the federal government to distribute health insurance tax credits in about two-thirds of the states. Some wording in one section of the law is the source of the dispute -- an ambiguity that Congress could fix with a simple, one-line correction. Coats, speaking to the Wall Street Journal's Louise Radnofsky, seemed to suggest he and other Republicans had no interest in taking that step.

It's possible Coats was being flippant. (His office has not responded to email inquiries from The Huffington Post.) And he doesn't necessarily speak for other Republicans, at least a few of whom have indicated they're thinking about what to do if the court does find for the plaintiffs.

Over the last few months, a cadre of prominent conservative writers and intellectuals -- most notably James Capretta, Philip Klein, Avik Roy and Yuval Levin -- have suggested Republicans seize the opportunity to enact their own version of health reform, whether that's through significant modifications to the existing law or some kind of wholesale replacement. The topic reportedly came up at a House Republican strategy retreat this month, and over in the Senate, Republicans Lamar Alexander, John Barrasso and Orrin Hatch have started a working group to examine possible post-King reforms.

"There are a lot of ideas," Hatch told TPM's Sahil Kapur this week. "If the case goes the way I think it should go ... then we've gotta come up with a way of resolving the problems we're in. We're quietly looking at all that and trying to do that."

But drawing up a health care bill can't really be done "quietly" -- or quickly. The debate over the Affordable Care Act dragged on for more than a year in Congress. And that was just the final stage of a process that had unfolded over roughly a decade, during which time liberal intellectuals and interest groups hashed out different ideas for how to write legislation and then how to build a political coalition that could pass it. It took such a long time because devising even narrowly tailored health care legislation requires coming to grips with difficult trade-offs -- and then dealing with politically powerful constituencies that might not like them.

Republicans would face the very same difficulties. Many conservatives have said, for example, that they would prefer to repeal or at least relax Obamacare's restrictions on "age rating," thereby allowing insurers much more room to vary premiums based on age. They tout this proposal because, they note correctly, it would mean lower premiums for young people. What they often don't mention is that it would also mean higher premiums for old people. In other words, giving a break to twenty-somethings would mean sticking it to those nearer retirement. Explaining that to older Americans now getting coverage wouldn't be easy for Republicans, particularly since older voters are a key part of the GOP constituency.

Of course, Republicans strategizing about a King ruling may not be acting in good faith. Nobody knows how the court will rule or what reasoning the individual justices will invoke in their decisions. But lots of people in Washington believe that Chief Justice John Roberts, whose vote to uphold the individual mandate saved Obamacare in 2012, might be inclined to save it again if he fears upholding the King lawsuit would wreak havoc -- not only by depriving millions of insurance, but also by throwing entire state insurance markets into chaos. (Without the subsidies, most experts say, many of the law's other reforms could not work and would lead to sudden spikes in premiums or a mass exodus of insurers.)

If Republicans make it look like they're prepared to act, the thinking goes, that will ease Roberts' conscience and make it easier for him to rule in favor of the lawsuit. For now, as one conservative health policy adviser told Kapur, the main goal of Republicans is to "make the world safe for Roberts to overturn." It'd be a smart gambit. But Coats' comments -- if representative of more widespread thinking -- would suggest that the mere appearance of trying to pass a law that preserves health insurance for millions is more than many conservatives can stomach.

HuffPost

BEFORE YOU GO

PHOTO GALLERY
Health Care Reform Efforts Throughout History
CONVERSATIONS