If you want to know about the Republican Party’s priorities for health care, pay close attention to what transpired -- and what didn’t transpire -- on Capitol Hill Tuesday.
The House Ways and Means Committee held a session to consider a number of health care-related measures. In theory, it would have been an ideal time to take up, amend and maybe even vote on a contingency plan for King v. Burwell -- the case before the Supreme Court that could wipe out health insurance tax credits under the Affordable Care Act for more than 6 million people scattered across two-thirds of the states.
The Ways and Means chairman, Rep. Paul Ryan (R-Wis.), has said repeatedly that his party will have a contingency plan ready to go if the court sides with the law’s challengers. He’s also vowed, again and again, to craft an Obamacare alternative that will achieve better results at lower costs. It’s the same set of promises that countless other Republican leaders have made, although Ryan would seem uniquely positioned to deliver on them. He is supposed to be the leading policy intellectual of his party, plus he presides over a powerful committee with direct jurisdiction over health care financing.
But take a look at the official agenda for the Ways and Means Committee on Tuesday. You’ll see a bill to repeal Obamacare’s tax on medical device makers and a proposal to repeal the so-called Independent Payment Advisory Board, which sets reimbursement rates under Medicare. You’ll see some other legislation, too, including some other adjustments to Medicare.
Here’s what you won’t see: contingency plans for the upcoming Supreme Court ruling or alternative schemes for expanding insurance coverage.
So no, Paul Ryan was never going to fix Obamacare should the Supreme Court break it in a matter of weeks. And as Greg Sargent points out, Republicans really don't give a good god damn about poor people anyway and if that's the case, they'll face voters in 2016:
Untold numbers of these people could lose coverage. In many of these states, vulnerable GOP incumbent Senators face reelection. If the Court rules against the government, presumably they’d be asked if they’ll support Congress doing a simple fix to keep subsidies flowing to hundreds of thousands of their constituents. (It’s no accident that vulnerable Wisconsin Senator Ron Johnson rushed out his own contingency plan.) Two presidential contenders — Jeb Bush and Marco Rubio — come from the state where well over a million people will lose subsidies.
It’s not yet clear how much all this will matter for the presidential and Senate races, but many Republicans appear worried. And Democrats will certainly try to make it matter.
Meanwhile, many state officials from red states that stand to lose subsidies are concluding that they don’t have any real options to fix subsidies themselves. Even in states where some want to do that, other Republicans may stand in the way. If that happens, state officials will likely demand that the federal government — meaning Congressional Republicans — act. Scott Walker is already doing this. But it’s looking like Congressional Republicans won’t act. Even if they do manage to offer a contingency fix, it will likely also repeal the provisions that make Obamacare work — which means it will be all about drawing a presidential veto for the political blame game that follows.
Thus, in all probability nothing will be done for all these people, leading to a very nasty, protracted political battle over the fallout. Which explains why Republicans are already laying plans to blame Obama and Democrats for it.
That's the plan: take affordable health insurance away from tens of millions and blame Obama when it happens.
If Republicans run on that in 2016, they are toast.