The U.S. flag flies in front of the West Front of the Supreme Court Building on August 7, 2009 in Washington, D.C. Judge Sonia Sotomayor will be sworn in as the 111th justice of the Supreme Court on Saturday.National Journal

This article is from the archive of our partner National Journal

If the Supreme Court rules this summer as Republicans hope it will and invalidates Obamacare's financial assistance in more than 30 states, members of Congress will have to figure out what to do next. They won't lack for options.

At least four so-called fixes to the King v. Burwell case, which could strip as many as 8 million people of the law's tax subsidies if the conservative argument prevails, have been formally introduced as legislation or floated in various op-eds and briefs in the last few months. They range from the ambitious, remaking the Affordable Care Act in a conservative image, to the simple, preventing the loss of subsidies but otherwise maintaining the status quo until (presumably) a new Republican president and Congress could address health care reform on their own terms in 2017.

The legislating serves a number of ends for the GOP, which risks shouldering the blame if millions lose health coverage because of a lawsuit it supports. It signals to the justices that Congress would be ready to act if the Court nixed the subsidies on the federal exchange. It also establishes early negotiating positions for any future talks with the Obama administration, which will surely be eager to avert disaster for the president's signature domestic policy.

The Court likely won't rule until June, but GOP lawmakers will be making choices in the next few weeks that could influence their post-King game plan. The party is already starting to fissure. Some far-right conservatives want to use the budget and the process known as reconciliation, which would require only 50 votes in the Senate, to fully repeal Obamacare. Leadership, on the other hand, is at least considering using reconciliation instead to pass a King fix.

Eventually, if it comes to that, Republicans will have to pick one plan to coalesce around. But for now, here are their competing ideas for cleaning up the mess.

Sen. Ron Johnson

Introduced 4/20/2015.

31 cosponsors, including Sens. Mitch McConnell, John Barrasso, Lindsey Graham, and Orrin Hatch.

Johnson's bill would extend subsidies eliminated by King until August of 2017, giving the government time to come up with a long-term solution, while also repealing Obamacare's individual and employer mandates.

—Individuals can keep any health care plan and subsidy until August 2017.—They could also decide whether to purchase any new insurance plan on the market.—The individual and employer mandates would be eliminated.—Essential health benefits and benefit packages would be amended to those defined by the state in which a health plan is offered.

    "This bill is a first step toward reversing the damage that Obamacare has inflicted on the American health care system," Johnson wrote in a statement. "It begins to replace Obamacare's expensive mess with patient-focused, market-based reforms."

    Reps. Paul Ryan, John Kline, and Fred Upton

    Introduced 3/2/2015.

    The plan from three House committee chairmen offers a tax credit to those currently receiving subsidies on federal exchanges. It also sets up a system that would let states opt out of Obamacare and opt into the GOP's plan, which repeals the law's mandates and allows insurance to be sold across state lines, but keeps some of the ACA's more popular provisions.

    —Those who lost assistance after the court ruling could receive a tax credit.—States could opt out of the ACA's individual and employer mandates.—Insurance could be bought across state lines.—Small businesses could band together to increase their bargaining power against insurance companies.—Adult children could still stay on their parents' insurance until age 26.—There would be protections for preexisting conditions and no lifetime limits on benefits.—People already enrolled in a plan would have guaranteed renewability.

      "Under ObamaCare, government controls your choices. Under our proposal, you will. You'll get to pick a plan that works for you," the sponsors wrote in a Wall Street Journal op-ed.

      Sens. Orrin Hatch, Lamar Alexander, and John Barrasso

      Introduced 3/1/2015.

      The senators, two of whom are key committee chairs, have proposed a transitional period in which financial assistance will be given to help people keep their coverage, although it's unclear how long this period will last. Their proposal also allows all states to create their own health insurance markets, which the senators argue would be better suited to the needs of their citizens.

      —There will be a transitional period in which financial assistance will be given to help people keep their coverage.—States will be able to create their own competitive health insurance markets, including those with state exchanges.—States with state exchanges—and therefore unaffected by the court ruling—would remain under Obamacare, including its mandates and subsidies.

        "Republicans have a plan to create a bridge away from Obamacare," the sponsors wrote in a Washington Post op-ed. "It would be unfair to allow families to lose their coverage, particularly in the middle of the year."

        Sen. Ben Sasse

        Introduced 3/4/2015.

        No cosponsors.

        Sasse would allow Obamacare enrollees to keep their health coverage and continue receiving financial assistance, through something akin to COBRA coverage, for a set amount of time while prohibiting the Department of Health and Human Services from letting states use HealthCare.gov's technology, which some theorized could be done by the Obama administration as a "workaround" to establish state exchanges and let the subsidies continue everywhere.

        —Individuals could continue receiving ACA plans and would receive financial assistance for 18 months after the Court ruling, which would roughly run through the end of 2016 or into early 2017, depending on the start date.

        —HHS would be prohibited from renting or selling HealthCare.gov's technology to states as a "bureaucratic workaround."

          "In the event that the court strikes down the subsidies as illegal, Congress must be prepared to offer immediate, targeted protection to those hurt by this administration's reckless disregard for the rule of law," Sasse wrote in a Feb. 25 Wall Street Journal op-ed. "ObamaCare took these patients hostage. Conservatives have a duty to save them."

          This story has been updated.

          Sen. Ron Johnson

          Introduced 4/20/2015.

          31 cosponsors, including Sens. Mitch McConnell, John Barrasso, Lindsey Graham, and Orrin Hatch.

          Johnson's bill would extend subsidies eliminated by King until August of 2017, giving the government time to come up with a long-term solution, while also repealing Obamacare's individual and employer mandates.

          —Individuals can keep any health care plan and subsidy until August 2017.—They could also decide whether to purchase any new insurance plan on the market.—The individual and employer mandates would be eliminated.—Essential health benefits and benefit packages would be amended to those defined by the state in which a health plan is offered.

            "This bill is a first step toward reversing the damage that Obamacare has inflicted on the American health care system," Johnson wrote in a statement. "It begins to replace Obamacare's expensive mess with patient-focused, market-based reforms."

            Reps. Paul Ryan, John Kline, and Fred Upton

            Introduced 3/2/2015.

            The plan from three House committee chairmen offers a tax credit to those currently receiving subsidies on federal exchanges. It also sets up a system that would let states opt out of Obamacare and opt into the GOP's plan, which repeals the law's mandates and allows insurance to be sold across state lines, but keeps some of the ACA's more popular provisions.

            —Those who lost assistance after the court ruling could receive a tax credit.—States could opt out of the ACA's individual and employer mandates.—Insurance could be bought across state lines.—Small businesses could band together to increase their bargaining power against insurance companies.—Adult children could still stay on their parents' insurance until age 26.—There would be protections for preexisting conditions and no lifetime limits on benefits.—People already enrolled in a plan would have guaranteed renewability.

              "Under ObamaCare, government controls your choices. Under our proposal, you will. You'll get to pick a plan that works for you," the sponsors wrote in a Wall Street Journal op-ed.

              Sens. Orrin Hatch, Lamar Alexander, and John Barrasso

              Introduced 3/1/2015.

              The senators, two of whom are key committee chairs, have proposed a transitional period in which financial assistance will be given to help people keep their coverage, although it's unclear how long this period will last. Their proposal also allows all states to create their own health insurance markets, which the senators argue would be better suited to the needs of their citizens.

              —There will be a transitional period in which financial assistance will be given to help people keep their coverage.—States will be able to create their own competitive health insurance markets, including those with state exchanges.—States with state exchanges—and therefore unaffected by the court ruling—would remain under Obamacare, including its mandates and subsidies.

                "Republicans have a plan to create a bridge away from Obamacare," the sponsors wrote in a Washington Post op-ed. "It would be unfair to allow families to lose their coverage, particularly in the middle of the year."

                Sen. Ben Sasse

                Introduced 3/4/2015.

                No cosponsors.

                Sasse would allow Obamacare enrollees to keep their health coverage and continue receiving financial assistance, through something akin to COBRA coverage, for a set amount of time while prohibiting the Department of Health and Human Services from letting states use HealthCare.gov's technology, which some theorized could be done by the Obama administration as a "workaround" to establish state exchanges and let the subsidies continue everywhere.

                —Individuals could continue receiving ACA plans and would receive financial assistance for 18 months after the Court ruling, which would roughly run through the end of 2016 or into early 2017, depending on the start date.

                —HHS would be prohibited from renting or selling HealthCare.gov's technology to states as a "bureaucratic workaround."

                  "In the event that the court strikes down the subsidies as illegal, Congress must be prepared to offer immediate, targeted protection to those hurt by this administration's reckless disregard for the rule of law," Sasse wrote in a Feb. 25 Wall Street Journal op-ed. "ObamaCare took these patients hostage. Conservatives have a duty to save them."

                  This story has been updated.

                  This article is from the archive of our partner National Journal.

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