A Tea Party member reaches for a pamphlet titled "The Impact of Obamacare", at a "Food for Free Minds Tea Party Rally" in Littleton, New Hampshire in this October 27, 2012.
Jessica Rinaldi/Reuters

GOP faces health care challenge it’s totally unprepared for

We don’t yet know what the Supreme Court will do in the King v. Burwell case, but we have a fairly good sense what will happen if the Supreme Court sides with Republicans. In effect, there will be chaos that could do considerable harm to insurers, families, state budgets, the federal budget, hospitals, and low-income children.
It sounds melodramatic, but the fact remains that if the GOP prevails, more Americans will literally go bankrupt and/or die as a result of this ruling.
With this in mind, I couldn’t help but find some sardonic humor in the House Republicans’ request for information from the Obama administration yesterday.
Senior House Republicans are demanding that the Obama administration reveal its contingency plans in the event that the Supreme Court scraps Obamacare subsidies in three dozen states. […]
“Specifically, we are examining the extent to which the Department of Health and Human Services (HHS), and other relevant agencies of the federal government, are preparing for the possible consequences of the Supreme Court’s decision in the case of King v. Burwell,” wrote the lawmakers.
The fact that the GOP lawmakers didn’t appreciate the irony was itself unfortunate, but the simple truth is that the underlying question – what happens if the Supreme Court takes this stupid case seriously and guts the American health care system? – is one Republicans should be answering, not asking.
If we had a normal, functioning political system, represented by two mainstream governing parties, the solution would be incredibly simple. If the Supreme Court said the language in the Affordable Care Act needed clarification, lawmakers would simply approve more specific language before Americans felt adverse consequences. The legislative fix would be quite brief and the whole process could be wrapped up in an afternoon.
No one, in this scenario, would actually suffer.
But in 2015, Americans don’t have the benefits of a normal, functioning political system, represented by two mainstream governing parties. On the contrary, we have a dysfunctional Congress led by a radicalized, post-policy party that has no use for governing, and which welcomes adverse consequences no matter how many Americans suffer.
And the question for them is what they intend to do if, like the dog that catches the car, Republican justices on the Supreme Court rule their way in the King v. Burwell case. Sahil Kapur had a terrific report on this overnight.
Many Republicans would view it as a dream come true if the Supreme Court were to slash a centerpiece of Obamacare by the end of June. But that dream could fade into a nightmare as the spotlight turns to the Republican Congress to fix the mayhem that could ensue.
“It’s an opportunity that we’ve failed at for two decades. We’ve not been particularly close to being on the same page on this subject for two decades,” said a congressional Republican health policy aide who was granted anonymity to speak candidly. “So this idea – we’re ready to go? Actually no, we’re not.”
Republican leaders recognize the dilemma. In King v. Burwell, they roundly claim the court ought to invalidate insurance subsidies in some three-dozen states, and that Congress must be ready with a response once they do. But conversations with more than a dozen GOP lawmakers and aides indicate that the party is nowhere close to a solution. Outside health policy experts consulted by the Republicans are also at odds on how the party should respond.
Republicans could approve a simple legislative fix, but they don’t want to. Republicans could introduce their ACA alternative, but they don’t want to do that, either. They could encourage states to create their own exchange marketplaces, largely negating the crisis, but they don’t want to do that, either.
So what do GOP lawmakers want? They haven’t the foggiest idea.
Kapur talked to a GOP aide who works on health care policy on Capitol Hill who said, “Our guys feel like: King wins, game over, we win. No. In fact: King wins, they [the Obama administration and Democrats] hold a lot of high cards. And we hold what?”
Millions of families who would be screwed by Republican victory in this case will be eager to hear an answer to that question.