Congressional Republicans are inching closer to a consensus about how their party would respond if the Supreme Court invalidates Obamacare's financial aid in 30-plus states in the coming weeks—but they aren't quite there yet.
House leaders presented a plan to their conference Wednesday, though aides and lawmakers emphasized that it is still a work in progress. The proposal, as described by GOP aides and members, would:
- Continue the Affordable Care Act's subsidies through the end of 2015, absent a Court stay of its decision that did the same.
- Immediately repeal the individual and employer mandates.
- Starting in 2016, states would be allowed to opt out of the law and its other various regulations. States would receive a block grant, the same amount as the subsidies that their residents would receive, to implement their own health care plans.
- In states that don't opt out, individuals would continue to receive subsidies but could use them to purchase plans on and off of the ACA exchanges.
- The plan would sunset in 2017, compelling a new Congress and president to come up with a comprehensive Obamacare replacement.
Ways and Means Chairman Paul Ryan outlined the plan during the closed-door discussion, members said, but he declined to discuss it in detail afterward. "We will customize it when we get the ruling itself," he said.
The Supreme Court case, King v. Burwell, is brought by conservative opponents of the law and challenges the legality of subsidies offered on federal exchanges, which operate in more than 30 states and through which more than 6 million people receive the law's financial assistance.
Rank-and-file House members expressed general support for the concept as they exited the meeting.
"It's very encouraging that we have come up with what I think is a good solution," Rep. Carlos Curbelo said in an interview. "I think, from what I could tell, most people are satisfied with the alternative that's been crafted." Curbelo has 83,000 constituents in Florida who could lose subsidies, according to the pro-ACA group Families USA.
"I think it's a good plan. It's a good start," said Republican Rep. Charles Boustany.
But some more conservative members might still need convincing.
"I think there's some that are worried that we're going to be blamed for maintaining a system of subsidies that we think is a bad idea," Rep. John Fleming told reporters, though he said he liked parts of the proposal. "But the case is being made that this is a transition, it's an off-ramp to a post-Obamacare plan, which will be a patient-centered, market-based plan."
The House plan is also almost certain to draw opposition from Democrats and the White House—particularly the individual-mandate repeal, which they argue would make the law as a whole untenable and make insurance unaffordable. President Obama has urged Congress to pass a one-sentence bill that authorizes the subsidies in every state if the Court rules against his administration.
Republican senators have not yet united behind one of several plans put forth in the upper chamber and did not reach a consensus during a membership meeting also held today. While most senators emerged from it expressing support for an extension of subsidies, at least one still hasn't jumped on board.
"I do not believe we should extend subsidies. I think the proper answer is to allow states to opt out," Sen. Ted Cruz told reporters.
The plans put forth in the Senate so far aren't identical to the one pitched by the House, but leadership expressed confidence that they'll come together.
"Well, we're working very closely together. I would fully expect the Senate and House will unite behind a single plan," said Sen. Lamar Alexander, chairman of the Senate Health, Education, Labor and Pensions committee.
Sen. Ron Johnson, the author of one of the leading plans, said allowing states to opt out of Obamacare "complements perfectly" his plan, and that he has always expected adjustments if and when it's taken to committee. The bill currently has 31 cosponsors and extends subsidies until August 2017. It also repeals the individual and employer mandates.
"I always expected that the committee's jurisdiction would hopefully take up my base bill and then make the types of specific improvements to make it workable, and I think that's kind of the direction we're heading," Johnson said in an interview.
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Caitlin Owens is a health care reporter at National Journal. Her work has previously appeared in the Los Angeles Times, The News & Observer and The Charlotte Observer. She is a graduate of the University of North Carolina at Chapel Hill.