Republican guru Karl Rove has urged the GOP to be ready with an alternative healthcare plan if the Supreme Court rules next month against eight million Americans receiving subsidies under Obamacare.
The nation's top court has been listening to arguments in the King v. Burwell case that could result in Obamacare enrollees in 34 states losing thousands of dollars each that they receive through federal exchanges, with most of them then unable to afford their insurance coverage.
In an opinion column for
The Wall Street Journal, Rove has warned Republican leaders to quickly come up with a fallback plan or face the wrath of voters ahead of the 2016 presidential election.
"President Barack Obama will accuse conservative justices of overreaching and demand that the GOP Congress immediately extend subsidies to every state," Rove said.
"His message will be politically potent, as it will turn the words of Republicans in 2013 back on them: 'If you like your plan,' Republicans said, 'you should be able to keep your plan.'
"Hillary Clinton will join in depicting Republicans as heartless brutes who would let people die for lack of health insurance rather than fix Mr. Obama's law."
The
legal battle centers on the actual language of the law, which says subsidies should only go to people who buy insurance on marketplaces "established by the state." But only 13 states have established such exchanges, while the residents of 34 states get their insurance through a federal marketplace.
Without subsidies, the young and healthy may opt out of insurance and risk tax penalties instead, while the elderly and more infirm are likely to continue paying for insurance. But the law needs the younger customers to counter-balance the costs of the older enrollees.
The loss of millions of healthy enrollees could result in the ultimate demise of vital sections of the Affordable Care Act, leading to the so-called death spiral of Obama's signature domestic policy.
But Obamacare supporters say the intention of the law was clear, and that every person was entitled to subsidies whether they enrolled with the federal exchange HealthCare.gov or the state-run exchanges.
Rove, a former deputy chief of staff under President George W. Bush, says that "fortunately" Republicans have been mulling over how to handle healthcare coverage if the Supreme Court rules against the government in a decision expected in June.
"The challenge will be to build consensus for one bill, choosing from the many ideas now being discussed," writes the political strategist.
"The proposals that have been floated so far fall under two general approaches. The first emphasizes providing transitional coverage for those affected by the loss of subsidies, while replacing selected elements of Obamacare.
"The second also includes transitional coverage but puts more emphasis on replacing and reforming Obamacare. Both approaches are predicated on the belief that wholesale repeal and replacement of the law is impossible until a Republican is president."
Rove, who founded the political-action committee American Crossroads, says that it would not be easy to settle on an alternative healthcare coverage bill.
"How long should transitional assistance last?" he posited. "What form should it take? Should it be means-tested or a flat amount? What Obamacare elements should be replaced?"
Rove noted that GOP Sens. Ron Johnson and Ben Sasse have come up with a plan following the first approach, while Republican Reps. Paul Ryan, John Kline and Fred Upton have proposed a package that follows the second approach.
Sens. Orrin Hatch, Richard Burr, Lamar Alexander and John Barrasso have also come up with various suggestions between them.
Rove concluded by saying: "Some Republicans may insist on simply repealing Obamacare. But doing this would chew up valuable time and give the president a veto opportunity he relishes.
"For now, Republicans should focus on putting Mr. Obama on the defensive with a proposal that makes sense to Americans."
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