The Supreme Court is taking its sweet time in handing down a ruling in King v. Burwell, leaving us poor saps who write about politics for a living to find new, semi-exciting ways to opine on the anticipated fallout from the decision. Thankfully, the ongoing holding period has provided enough space for politicians of national importance to weigh in and offer their eminently take-worthy opinions on what should happen following the high court’s ruling.
As you may or may not be aware, King v. Burwell deals with the legality of the Affordable Care Act’s health insurance subsidies in states that rely on the federal government to run their insurance marketplaces. Conservatives and Republicans have embraced a tortured and bad-faith interpretation of the ACA to argue that the subsidies must be shut off. Killing those subsidies would do significant damage to the law, but it would also put millions at risk of losing their health insurance, and so Republicans are feverishly trying to work out a way to escape any political damage from their by-all-means crusade to cripple Obamacare.
To date, their efforts have been marred by intractable divisions within the party over what the GOP’s priorities should be when it comes to Obamacare specifically and health policy generally. And as more politicians weigh in, the divide only gets worse.
Rick Perry, the former governor of Texas and recent entrant into the 2016 presidential race, just recently said he would support temporarily extending the ACA’s insurance subsidies if the court strikes them down. “We moved a long way when this thing became law,” he told RealClearPolitics. “You don’t turn around a huge ship just overnight. It takes a transition period. I think most Americans, whether they’re strict conservatives economically, would find that to be out of the realm of appropriate.” Perry’s position puts him in line with a good number of Republicans in Congress, who have proposed several terrible plans for extending the subsidies while killing off other critical components of the ACA.
It puts him at odds, though, with two other prominent Texas Republicans. As RCP noted, Perry’s position contradicts that of his fellow 2016 candidate, Sen. Ted Cruz. Cruz has flat-out rejected any sort of extension for the subsidies, and instead called for legislation allowing states to “opt-out” of Obamacare. Yesterday, Cruz’s “hell no” stance was joined by the current governor of Texas, Greg Abbott, who wrote a column for National Review lashing out at “politicians from both sides of the aisle” who “are lining up to rescue Obamacare from itself.” Per Abbott: “Now is not the time to throw Obamacare a lifeline — it is time to sound its death knell.”
Statements like these from Abbott and Cruz are significant, given that the state they represent has a lot riding on the outcome of this case. According to data from the Kaiser Family Foundation, Texas is second only to Florida when it comes to the number of people who could lose their health insurance subsidies, with over 800,000 people at risk. For a conservative who believes that the subsidies should stay dead if the court kills them, testimonials from the governor of Texas and the state’s junior senator offer powerful affirmations that they should not work out a deal.
Republicans will also be under intense pressure from well-funded conservative activist groups to resist extending subsidies. Last week, Rep. Paul Gosar, R-Ariz., introduced legislation that would get rid of the ACA’s “onerous insurance regulations” and leave the subsidy issue untouched. Gosar’s bill has already been endorsed by Heritage Action, which describes it as the “conservative response to King v. Burwell” and leaves no doubt where it stands on subsidies: “A continuation of illegal subsidies will simply cover up the law’s costs while giving the impression Republicans believe subsidies are necessary for Americans to afford health insurance.” And as the New York Times reports, Americans for Prosperity, the Koch brothers’ primary vehicle for political activism, is promising to apply pressure to block state governments from setting up their own healthcare exchanges to get the subsidies flowing again. The last thing any Republican wants is a primary challenger from the right who can make the case that they’ve been uncommitted to repealing Obamacare.
What you’re left with is one ugly and disastrous mess in the making. Republican leaders in Congress are insisting to anyone who’ll listen that they’ll be ready with a response if the Supreme Court sides with the plaintiffs in King v. Burwell. And yet even as they say this, you see fights breaking out at pretty much every level of Republican politics over what the party should do and what the true “conservative” response to a King ruling should be. Those fights are why congressional Republicans don’t want to openly commit to a post-King plan, and they’re also why so few 2016 candidates have taken a firm position on what the GOP should do. No one wants to stick their neck out until the Supreme Court makes it necessary to do so.