Congressional Republicans have yet to unite behind any of the growing number of proposals for responding to a Supreme Court ruling that could void federal subsidies that millions of people use to buy coverage under President Barack Obama's health care law. The decision is expected by June.
Those proposing plans include:
— Sen. Orrin Hatch, R-Utah, John Barrasso, R-Wyo., and Lamar Alexander, R-Tenn.: Provide temporary financial assistance to people losing subsidies. Give states more flexibility to design requirements for insurance coverage. Not yet introduced, no details.
— Reps. Paul Ryan, R-Wis., Fred Upton, R-Mich., John Kline, R-Minn.: Tax credits for people who lose subsidies, growing in size for older people. Full credit would be paid to people not owing taxes. States could ignore health care law's requirements that plans cover certain basic services. Not yet introduced, no details.
— Sen. Ron Johnson, R-Wis.: Allow people losing health policies or subsidies due to the court ruling to keep them until August 2017. Eliminate requirements that individuals buy coverage and that companies offer coverage to workers. Introduced April 20; 31 co-sponsors include Senate Majority Leader Mitch McConnell, R-Ky., and other members of Senate GOP leadership.
— Sen Ben Sasse, R-Neb.: People losing coverage from court ruling could keep it for 18 months. People losing subsidies could get health care tax credits that would gradually shrink, disappearing after 18 months. Introduced March 4, no co-sponsors.
— Rep. Bill Flores, R-Texas, and members of the Republican Study Committee, a group of conservative lawmakers: Expected to repeal entire health overhaul law, create new tax deductions for families and many businesses, expand health savings accounts. Not introduced, no details.
Congressional Republicans are divided over how to respond to an approaching Supreme Court decision on President Barack Obama's health care law, even as growing numbers concede that their long-sought goal of repealing the statute will have to wait.
Should the plaintiffs prevail in the GOP-backed lawsuit, the justices could annul one of the law's backbones: federal subsidies helping around 7.7 million people afford health insurance in more than 30 states. Republicans broadly agree that Congress should react by temporarily replacing that aid, aware that abruptly ending it would anger millions of voters before the 2016 presidential and congressional elections.
Yet when it comes to choosing an overall response to a court ruling, GOP lawmakers have suggested at least five different proposals — so far. None has won consensus backing from Republicans.
The divisions underscore the challenge Republicans face between satisfying conservative supporters who want the law dismantled and providing help should millions lose their ability to afford coverage. But the sheer existence of the GOP proposals could help in court because it might suggest to the justices that despite Democrats' claims that eliminating the subsidies would spark health insurance chaos, Congress is already working on ways to avoid that.
Republicans say they remain uniformly intent on dismantling the 2010 law, but there's also no agreement on what the replacement should be. Increasingly, many acknowledge that as long as Obama remains in office, any repeal effort will mostly serve to tee up the issue for the 2016 elections.
"I think it needs to be part of the presidential campaign, and then the winner will be able to point to that as part of their mandate," said No. 2 Senate GOP leader John Cornyn of Texas. Meanwhile, he said, "what we all need to do is unite around one approach, if that's at all possible, and that's been a challenge because there are competing good ideas out there."
Sen. John Barrasso, R-Wyo., is helping to craft a plan he says would temporarily protect people who lose subsidies and eliminate the law's requirements that individuals buy coverage and that companies cover their workers. He said that would "allow the full replacement debate to be the 2016 election campaign, and then a Republican in the White House in 2017 who'll actually sign" alternative legislation.
Sen. Ron Johnson, R-Wis., who faces a tight re-election race next year, would extend the current subsidies until August 2017 but also eliminate the coverage requirements for individuals and employers, which Obama considers key parts of the law and would be unlikely to accept. Conservative freshman Sen. Ben Sasse, R-Neb., has introduced narrower legislation replacing the current subsidies with a new tax credit that would be phased out over 18 months as Congress worked on a broader response.
Some conservatives prefer to focus on repeal. One large group of House conservatives led by Rep. Bill Flores, R-Texas, is writing a plan expected to revoke the entire law and instead provide new health care tax deductions for families.
"What did we tell the voters last November? We told them we're committed to getting rid of this law," said Rep. Jim Jordan, R-Ohio, a leading House conservative. "Put it on the president's desk, actually make him veto it."
Republicans will be able to use special budget rules this year shielding legislation addressing the health law from Senate filibusters, which take 60 votes — a difficult hurdle — to end. Rep. Paul Ryan, R-Wis., says that once the court has ruled, GOP leaders will decide whether to use that process to send Obama legislation repealing the health care overhaul or addressing the justices' ruling.
Ryan, chairman of the House Ways and Means Committee, is working on one replacement bill with other lawmakers.
"I don't think the guy named Obama will sign a law repealing Obamacare," said Ryan, using a nickname for the law. He said if the court annuls the subsidies, "what happens? And that's where it's open-ended."
The House voted in February to repeal the health care law, as it has dozens of times since 2011.
The Senate hasn't voted on repeal yet. Such a vote could be difficult for the half-dozen GOP senators facing competitive re-election fights in closely divided or Democratic-leaning states in 2016, when Senate control will be at stake.
The court should rule by late June.
Plaintiffs say the Obama administration is unlawfully providing subsidies to people buying health coverage in the 37 states using healthcare.gov, the federally run insurance marketplace. They say the law's language limits those subsidies to people purchasing policies on the 13 state-run insurance exchanges.
Of the 11.7 million Americans enrolling for health coverage through government-established marketplaces for 2015, nearly 9 million bought it in states using federally run exchanges, according to the Department of Health and Human Services. Of those 9 million, around 7.7 million qualified for subsidies, which they receive as tax credits.
Supporters say the law was intended to provide subsidies in all states. They say eliminating the payments would make many people drop coverage, driving up premiums for everyone else because only the sickest and most expensive recipients would retain their policies.
